Provider Demographics
NPI:1962243634
Name:LBM MEDICAL CLINIC LLC.
Entity type:Organization
Organization Name:LBM MEDICAL CLINIC LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LYNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:770-715-3536
Mailing Address - Street 1:701 FIRESIDE DR
Mailing Address - Street 2:
Mailing Address - City:AUBREY
Mailing Address - State:TX
Mailing Address - Zip Code:76227-1507
Mailing Address - Country:US
Mailing Address - Phone:770-715-3536
Mailing Address - Fax:903-998-1024
Practice Address - Street 1:707 S INTERSTATE 35 E STE 122
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76205-8101
Practice Address - Country:US
Practice Address - Phone:903-519-6046
Practice Address - Fax:903-998-1024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-05
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty