Provider Demographics
NPI:1578569893
Name:CONSULTANTS IN INFECTIOUS DISEASES
Entity Type:Organization
Organization Name:CONSULTANTS IN INFECTIOUS DISEASES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:P
Authorized Official - Last Name:MARTINELLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-795-8150
Mailing Address - Street 1:PO BOX 16327
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79490-6327
Mailing Address - Country:US
Mailing Address - Phone:806-795-8150
Mailing Address - Fax:806-791-6688
Practice Address - Street 1:4404 C 19TH
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79407
Practice Address - Country:US
Practice Address - Phone:806-795-8150
Practice Address - Fax:806-791-6688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-22
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ3849207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0541920001OtherPALMETTO GBA
103131100OtherFIRST CARE
750678OtherBCBS HOME INFUSION THERAP
082062301OtherFIRST CARE STAR
G9939OtherNEW MEXICO MEDICAID
TX082062301Medicaid
CP3097Medicare PIN
G9939OtherNEW MEXICO MEDICAID