Provider Demographics
NPI:1407288954
Name:LOMAX, THEODORE FRANCIS JR
Entity Type:Individual
Prefix:
First Name:THEODORE
Middle Name:FRANCIS
Last Name:LOMAX
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:899 N CAPITOL ST NE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-4263
Mailing Address - Country:US
Mailing Address - Phone:202-444-5967
Mailing Address - Fax:202-442-9430
Practice Address - Street 1:899 N CAPITOL ST NE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-4263
Practice Address - Country:US
Practice Address - Phone:202-444-5967
Practice Address - Fax:202-442-9430
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-07
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker