Provider Demographics
NPI:1922723147
Name:KUMOCK PLLC
Entity Type:Organization
Organization Name:KUMOCK PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:H
Authorized Official - Last Name:LOMBARDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-347-2231
Mailing Address - Street 1:5122 MORNINGSIDE DR APT 815
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-2564
Mailing Address - Country:US
Mailing Address - Phone:630-347-2231
Mailing Address - Fax:
Practice Address - Street 1:1015 GIBBINS RD STE A
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76011-5615
Practice Address - Country:US
Practice Address - Phone:972-734-5400
Practice Address - Fax:972-734-5433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-10
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty