Provider Demographics
NPI:1538845607
Name:PULMCARE, LLC
Entity type:Organization
Organization Name:PULMCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAVANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:SRINIVASAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-731-8335
Mailing Address - Street 1:514 TIMBER LAKE DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-7204
Mailing Address - Country:US
Mailing Address - Phone:817-290-2239
Mailing Address - Fax:682-207-1030
Practice Address - Street 1:1001 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2228
Practice Address - Country:US
Practice Address - Phone:312-731-8335
Practice Address - Fax:682-207-1030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-23
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty