Provider Demographics
NPI:1790893576
Name:LLOMPART, JUAN A (MD)
Entity Type:Individual
Prefix:DR
First Name:JUAN
Middle Name:A
Last Name:LLOMPART
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:2705 HOSPITAL DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901
Mailing Address - Country:US
Mailing Address - Phone:361-572-5105
Mailing Address - Fax:361-582-1128
Practice Address - Street 1:2705 HOSPITAL DR
Practice Address - Street 2:SUITE 202
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901
Practice Address - Country:US
Practice Address - Phone:361-572-5105
Practice Address - Fax:361-582-1128
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2010-04-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXF9742207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX035878003Medicaid
TX035878003Medicaid
TX8157N0Medicare ID - Type Unspecified