Provider Demographics
NPI:1508892886
Name:LINGURAR, MAXINE A (MD)
Entity Type:Individual
Prefix:
First Name:MAXINE
Middle Name:A
Last Name:LINGURAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4327 BARNETT RD
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76310-2303
Mailing Address - Country:US
Mailing Address - Phone:940-764-5250
Mailing Address - Fax:940-764-5251
Practice Address - Street 1:4327 BARNETT RD
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76310-2303
Practice Address - Country:US
Practice Address - Phone:940-764-5200
Practice Address - Fax:940-764-5201
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS27331207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100316810DMedicaid
KS106702OtherBCBS
KS106702Medicare PIN
G67708Medicare UPIN