Provider Demographics
NPI:1790080109
Name:ROGER J LUNKE MD PA
Entity Type:Organization
Organization Name:ROGER J LUNKE MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:J
Authorized Official - Last Name:LUNKE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-490-7470
Mailing Address - Street 1:540 MADISON OAK DR STE 350
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-3921
Mailing Address - Country:US
Mailing Address - Phone:210-490-7470
Mailing Address - Fax:210-404-1464
Practice Address - Street 1:540 MADISON OAK DR STE 350
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-3921
Practice Address - Country:US
Practice Address - Phone:210-490-7470
Practice Address - Fax:210-404-1464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-14
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty