Provider Demographics
NPI:1194905588
Name:MARIA R LOMBA , M.D.,P.A.
Entity type:Organization
Organization Name:MARIA R LOMBA , M.D.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:R
Authorized Official - Last Name:LOMBA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:830-625-8200
Mailing Address - Street 1:1528 E COMMON ST
Mailing Address - Street 2:STE 18
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-3337
Mailing Address - Country:US
Mailing Address - Phone:830-625-8200
Mailing Address - Fax:830-620-6888
Practice Address - Street 1:1528 E COMMON ST
Practice Address - Street 2:STE 18
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-3337
Practice Address - Country:US
Practice Address - Phone:830-625-8200
Practice Address - Fax:830-620-6888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-14
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ5174174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00251LOtherBCBS
TX140812201Medicaid
TX140812201Medicaid