Provider Demographics
NPI:1346310588
Name:LAMANNA UROLOGY ASSOCIATES
Entity Type:Organization
Organization Name:LAMANNA UROLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:LAMANNA
Authorized Official - Suffix:III
Authorized Official - Credentials:DO
Authorized Official - Phone:214-330-5281
Mailing Address - Street 1:2909 S HAMPTON RD
Mailing Address - Street 2:SUITE 101D
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75224
Mailing Address - Country:US
Mailing Address - Phone:214-330-5281
Mailing Address - Fax:214-331-8194
Practice Address - Street 1:2909 S HAMPTON RD
Practice Address - Street 2:SUITE 101D
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75224
Practice Address - Country:US
Practice Address - Phone:214-330-5281
Practice Address - Fax:214-331-8194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2011-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF8765208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX10028893OtherAMERIGROUP
TX3774OtherPARKLAND
TX083601701Medicaid
TX083601701Medicaid
TX3774OtherPARKLAND