Provider Demographics
NPI:1699078568
Name:PANTHER INPATIENT CARE PLLC
Entity type:Organization
Organization Name:PANTHER INPATIENT CARE PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:PANTHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-262-2990
Mailing Address - Street 1:21710 EDEN ROSE HL
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78256-1670
Mailing Address - Country:US
Mailing Address - Phone:210-262-2990
Mailing Address - Fax:
Practice Address - Street 1:21710 EDEN ROSE HL
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78256-1670
Practice Address - Country:US
Practice Address - Phone:210-262-2990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-14
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXM8899OtherMEDICAL LICENSE