Provider Demographics
NPI:1467637108
Name:VILLAR-LAMUG PEDIATRICS PA
Entity Type:Organization
Organization Name:VILLAR-LAMUG PEDIATRICS PA
Other - Org Name:BAYTOWN PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIETTA
Authorized Official - Middle Name:B
Authorized Official - Last Name:LAMUG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-422-3134
Mailing Address - Street 1:1610 JAMES BOWIE DR
Mailing Address - Street 2:SUITE B103
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77520-3357
Mailing Address - Country:US
Mailing Address - Phone:281-422-3134
Mailing Address - Fax:281-427-2811
Practice Address - Street 1:1610 JAMES BOWIE DR
Practice Address - Street 2:SUITE B103
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77520-3357
Practice Address - Country:US
Practice Address - Phone:281-422-3134
Practice Address - Fax:281-427-2811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-31
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0886174400000X
TXK0234174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
F85397OtherUPIN
G03325OtherUPIN