Provider Demographics
NPI:1609813252
Name:MCKINNEY, LORRAINE ELIZABETH (DPM)
Entity Type:Individual
Prefix:DR
First Name:LORRAINE
Middle Name:ELIZABETH
Last Name:MCKINNEY
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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 1:13201 NORTHWEST FWY STE 800
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77040
Practice Address - Country:US
Practice Address - Phone:281-402-3561
Practice Address - Fax:713-936-0303
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2018-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103300730213E00000X
TX1799213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX188511303Medicaid
TXP00450851OtherRAIL ROAD MEDICARE
TX1885113Medicaid
TX8J8842Medicare PIN
TX8J8841Medicare PIN
VAU77478Medicare UPIN
TX8F6530Medicare PIN
TX8J8839Medicare PIN
TX8J8840Medicare PIN
TX5663880001Medicare NSC