Provider Demographics
NPI:1558462978
Name:LIDIA LEMARROY
Entity Type:Organization
Organization Name:LIDIA LEMARROY
Other - Org Name:J OLI'S ORTHOPEDIC SHOES & MEDICAL SUPPLIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LIDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEMARROY
Authorized Official - Suffix:
Authorized Official - Credentials:CERTIFIED PEDORTHIST
Authorized Official - Phone:956-969-1323
Mailing Address - Street 1:309 S TEXAS BLVD
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-6113
Mailing Address - Country:US
Mailing Address - Phone:956-969-1323
Mailing Address - Fax:956-968-8803
Practice Address - Street 1:1305 S 10TH ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-5023
Practice Address - Country:US
Practice Address - Phone:956-687-4664
Practice Address - Fax:956-668-7453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX532309OtherBLUE CROSS BLUE SHIELD
TX016929401Medicaid
TX121001502Medicaid
TX532309OtherBLUE CROSS BLUE SHIELD