Provider Demographics
NPI:1710159140
Name:LANKERANI, LELA (DO)
Entity Type:Individual
Prefix:MS
First Name:LELA
Middle Name:
Last Name:LANKERANI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 S US HIGHWAY 281
Mailing Address - Street 2:
Mailing Address - City:MARBLE FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:78654-9703
Mailing Address - Country:US
Mailing Address - Phone:830-693-4800
Mailing Address - Fax:830-310-6380
Practice Address - Street 1:800 S US HIGHWAY 281
Practice Address - Street 2:
Practice Address - City:MARBLE FALLS
Practice Address - State:TX
Practice Address - Zip Code:78654-9703
Practice Address - Country:US
Practice Address - Phone:830-693-4800
Practice Address - Fax:830-626-9031
Is Sole Proprietor?:No
Enumeration Date:2008-03-26
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP9627207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8EH451OtherBCBS PROVIDER RECORD ID
TX348533YTAQMedicare PIN
TX348533YS4ZMedicare PIN