Provider Demographics
NPI:1336373513
Name:LMO HEALTHCARELLC
Entity type:Organization
Organization Name:LMO HEALTHCARELLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-858-9590
Mailing Address - Street 1:4161 E HIGHWAY 290
Mailing Address - Street 2:STE 400
Mailing Address - City:DRIPPING SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78620-4446
Mailing Address - Country:US
Mailing Address - Phone:512-858-9580
Mailing Address - Fax:512-858-9582
Practice Address - Street 1:4161 E HIGHWAY 290
Practice Address - Street 2:STE 400
Practice Address - City:DRIPPING SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:78620-4446
Practice Address - Country:US
Practice Address - Phone:512-858-9580
Practice Address - Fax:512-858-9582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-04
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty