Provider Demographics
NPI:1649376815
Name:ARANDIA-ANTELO, LUIS F (MD)
Entity type:Individual
Prefix:DR
First Name:LUIS
Middle Name:F
Last Name:ARANDIA-ANTELO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4020 21ST ST STE 2
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1126
Mailing Address - Country:US
Mailing Address - Phone:806-792-2847
Mailing Address - Fax:806-792-3429
Practice Address - Street 1:4020 21ST ST STE 2
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1126
Practice Address - Country:US
Practice Address - Phone:806-792-2847
Practice Address - Fax:806-792-3429
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8887208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG10442Medicare UPIN