KEVIN LANE DO PA NPI 1003001579

Family Medicine in Quanah, TX

About KEVIN LANE DO PA

Kevin Lane Do Pa is a provider in Quanah, TX. The NPI number assigned to this provider is 1003001579. The practitioner's primary taxonomy code is Family Medicine (207Q00000X). The provider is registered as an organization and their NPI record was last updated 10 years ago. Kevin Lane Do Pa operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The provider's is doing business as Kevin Lane Do.

NPI1003001579 Additional informationCallout TooltipNational Provider Indentifier (NPI)
The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider NameKEVIN LANE DO PA
Provider Location Address404 MERCER ST QUANAH, TX 79252 Additional informationCallout TooltipProvider location address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing AddressPO BOX 359 QUANAH, TX 79252 Additional informationCallout TooltipProvider mailing address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
NPI Entity TypeOrganization Additional informationCallout TooltipEntity type code
The code describing the type of health care provider that is being assigned an NPI.
Codes are:
1 = (Person): individual human being who furnishes health care;
2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor?N/A
Is Organization Subpart?No Additional informationCallout TooltipWhat is a subpart?
Subparts are the components and separate physical locations of organization health care providers. Examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Other Organization NameKEVIN LANE DO Additional informationCallout TooltipProvider other organization name
The alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. Codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.
Other Name TypeDoing Business As (3)
Enumeration Date09-07-2007 Additional informationCallout TooltipProvider enumeration date
The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date09-07-2007 Additional informationCallout TooltipLast update date
The date that a record was last updated or changed.

Business Address

KEVIN LANE DO PA
404 MERCER ST
QUANAH, TX
ZIP 79252
Phone: (940) 663-5111
Fax: (940) 663-5899
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Mailing Address

KEVIN LANE DO PA
PO BOX 359
QUANAH, TX
ZIP 79252
Phone: (940) 663-5111
Fax: (940) 663-5899

Primary Taxonomy

Taxonomy Code207Q00000X Additional informationCallout TooltipPrimary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
ClassificationFamily Medicine
TypeAllopathic & Osteopathic Physicians
License No.L8579
License StateTX
Taxonomy DescriptionFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Authorized Official

Authorized Official Name KIMBERLY R FLANNERY Additional informationCallout TooltipAuthorized official name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.
Authorized Official TitlePRACTICE ADMINISTRATOR
Authorized Official Phone(940) 663-5111

193400000X SINGLE SPECIALTY GROUP - This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
E87143MEDICARE UPIN (02)TX
00105YMEDICARE OSCAR/CERTIFICATION (06)TX

Map Location


KEVIN LANE DO PA address is 404 MERCER ST QUANAH, TX 79252

Other Providers at the same location


The following 4 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1619979044 KEVIN B LANE DO
Individual
Family Medicine404 MERCER ST
QUANAH, TX 79252
(940) 663-5111
1841740990MRS. FARA FAYTHE GARZA MSN, RN, FNP-C
Individual
Nurse Practitioner (Family)404 MERCER ST
QUANAH, TX 79252
(940) 663-6651
1922072214 EVA HORVATH MD
Individual
Family Medicine404 MERCER ST
QUANAH, TX 79252
(940) 663-6651
1932426772HARDEMAN COUNTY MEMORIAL HOSP
Organization
Clinic/Center (Rural Health)404 MERCER ST
QUANAH, TX 79252
(940) 663-6651