Provider Demographics
NPI:1942376520
Name:LIPINSKI, JAMES E (PA C)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:E
Last Name:LIPINSKI
Suffix:
Gender:M
Credentials:PA C
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:600 NORTH DAIRY ASHFORD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77064
Mailing Address - Country:US
Mailing Address - Phone:281-293-1881
Mailing Address - Fax:281-293-2526
Practice Address - Street 1:600 NORTH DAIRY ASHFORD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77064
Practice Address - Country:US
Practice Address - Phone:281-293-1881
Practice Address - Fax:281-293-2526
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK368363A00000X
TXPA08452363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKCL3490Medicaid
AKCL3490Medicaid
K150597Medicare ID - Type Unspecified