Provider Demographics
NPI:1982357968
Name:LBB MED CONSULTS
Entity Type:Organization
Organization Name:LBB MED CONSULTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AYESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCOY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-470-7483
Mailing Address - Street 1:22704 SH 404 LOOP
Mailing Address - Street 2:STE C
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:22704 SH 404 LOOP
Practice Address - Street 2:STE C
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339
Practice Address - Country:US
Practice Address - Phone:832-664-5653
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-31
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care