Provider Demographics
NPI:1245779834
Name:LMA PHARM PLLC
Entity type:Organization
Organization Name:LMA PHARM PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PIC
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:432-770-9737
Mailing Address - Street 1:225 JAKE DR
Mailing Address - Street 2:
Mailing Address - City:JARRELL
Mailing Address - State:TX
Mailing Address - Zip Code:76537-1774
Mailing Address - Country:US
Mailing Address - Phone:512-746-0901
Mailing Address - Fax:512-598-3779
Practice Address - Street 1:180 TOWN CENTER BLVD
Practice Address - Street 2:
Practice Address - City:JARRELL
Practice Address - State:TX
Practice Address - Zip Code:76537-4000
Practice Address - Country:US
Practice Address - Phone:512-746-0901
Practice Address - Fax:512-598-3779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-16
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TX315393336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2170902OtherPK
TX149674Medicaid