Provider Demographics
NPI:1932161072
Name:URQUIA, KARINA J (MD)
Entity type:Individual
Prefix:
First Name:KARINA
Middle Name:J
Last Name:URQUIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 155207
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75915-5207
Mailing Address - Country:US
Mailing Address - Phone:936-699-4000
Mailing Address - Fax:936-699-4001
Practice Address - Street 1:121 GASLIGHT MEDICAL PARKWAY
Practice Address - Street 2:SUITE 101
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904
Practice Address - Country:US
Practice Address - Phone:936-699-4000
Practice Address - Fax:936-699-4001
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL5159207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8P9154OtherBLUE CROSS
TX155327302Medicaid
TX8P9154OtherBLUE CROSS
TX8D4503Medicare PIN
TXH71937Medicare UPIN