Provider Demographics
NPI:1912145350
Name:PULMONARY DIAGNOSTICS & THERAPEUTICS PC
Entity Type:Organization
Organization Name:PULMONARY DIAGNOSTICS & THERAPEUTICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:LAMONT
Authorized Official - Last Name:WADE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:903-868-0634
Mailing Address - Street 1:2100 MONTE CRISTO DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092-3198
Mailing Address - Country:US
Mailing Address - Phone:903-868-0634
Mailing Address - Fax:903-870-4064
Practice Address - Street 1:2100 MONTE CRISTO DR
Practice Address - Street 2:SUITE C
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-3198
Practice Address - Country:US
Practice Address - Phone:903-868-0634
Practice Address - Fax:903-870-4064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-22
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty