Provider Demographics
NPI:1487837183
Name:LORRAINE E MCKINNEY DPM PLLC
Entity Type:Organization
Organization Name:LORRAINE E MCKINNEY DPM PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LORRAINE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:MCKINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:281-402-3561
Mailing Address - Street 1:PO BOX 38228
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77238-8228
Mailing Address - Country:US
Mailing Address - Phone:281-402-3561
Mailing Address - Fax:281-936-0303
Practice Address - Street 1:5751 BLYTHEWOOD ST STE 200
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77021-5404
Practice Address - Country:US
Practice Address - Phone:281-402-3561
Practice Address - Fax:281-936-0303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-17
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1799213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2111213Medicaid
TX6300770001Medicare NSC
TX00Y356Medicare PIN
U77478Medicare UPIN