Provider Demographics
NPI:1356339774
Name:LIPSCOMB, ALBERT BRANT (MD)
Entity type:Individual
Prefix:
First Name:ALBERT
Middle Name:BRANT
Last Name:LIPSCOMB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:6400 FANNIN ST STE 1700
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1526
Mailing Address - Country:US
Mailing Address - Phone:713-486-7500
Mailing Address - Fax:713-512-2234
Practice Address - Street 1:9305 PINECROFT DR STE 400
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3482
Practice Address - Country:US
Practice Address - Phone:713-486-8800
Practice Address - Fax:281-367-1323
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-10
Last Update Date:2018-10-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXH1508207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX105226803Medicaid
TXLI086M138Medicare ID - Type Unspecified
TXE54065Medicare UPIN