Organization Name: | MLMD PA |
NPI Number: | 1750540811 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARK L LOBAUGH (OWNER) |
Mailing Address: | 2111 S Clear Creek Rd Killeen |
State: | TX US |
Postal Code: | 765494110 |
Phone Number: | 2545192229 |
Fax Number: | 2545192231 |
NPI Enumeration Date: | 06/04/2008 |
NPI Last Update Date: | 12/31/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | L3544 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |