Provider Demographics
NPI:1598937781
Name:LOVE, LILY P (MD)
Entity Type:Individual
Prefix:DR
First Name:LILY
Middle Name:P
Last Name:LOVE
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 1:5929 BALCONES DR STE 200
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4280
Mailing Address - Country:US
Mailing Address - Phone:512-550-1800
Mailing Address - Fax:877-647-0202
Practice Address - Street 1:4901 LANG AVE NE STE 100
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-4597
Practice Address - Country:US
Practice Address - Phone:505-883-2574
Practice Address - Fax:877-647-0202
Is Sole Proprietor?:No
Enumeration Date:2008-03-27
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME101352207Y00000X
NY238246207Y00000X
LA026670207Y00000X
NMMD2009-0553207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL42730OtherBLUE CROSS BLUE SHIELD
FL000292200Medicaid
FL42730OtherBLUE CROSS BLUE SHIELD