Provider Demographics
NPI:1841395142
Name:LOMBA, MARIA R (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:R
Last Name:LOMBA
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 1:614C S. BUSINESS IH 35
Mailing Address - Street 2:BOX 82
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-4748
Mailing Address - Country:US
Mailing Address - Phone:210-387-5304
Mailing Address - Fax:
Practice Address - Street 1:2041 SUNDANCE PKWY
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-2779
Practice Address - Country:US
Practice Address - Phone:210-387-5304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ5174208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX140812201Medicaid
TX00251LOtherBCBS
TX8826B0Medicare PIN