Provider Demographics
NPI:1538439724
Name:LUNG DOCTORS FOR CHILDREN, PLLC
Entity type:Organization
Organization Name:LUNG DOCTORS FOR CHILDREN, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:M
Authorized Official - Last Name:REMBECKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:469-878-6185
Mailing Address - Street 1:751 W MAIN ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-3513
Mailing Address - Country:US
Mailing Address - Phone:927-219-5864
Mailing Address - Fax:972-219-5866
Practice Address - Street 1:751 W MAIN ST
Practice Address - Street 2:SUITE 200
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-3513
Practice Address - Country:US
Practice Address - Phone:927-219-5864
Practice Address - Fax:972-219-5866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-05
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ24612080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric PulmonologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2934692002OtherCIGNA
TX015857-0082OtherPACIFICARE
TX1151805-04Medicaid
TX2916754OtherAETNA
TXA003OtherTRICARE
TX2916754OtherAETNA
TX86582FMedicare PIN