Provider Demographics
NPI:1023282191
Name:DR. FRANCIS LANSANG, MD PA
Entity type:Organization
Organization Name:DR. FRANCIS LANSANG, MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMIN. ASSISTANT/CREDENTIALING
Authorized Official - Prefix:MS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:E
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-272-4524
Mailing Address - Street 1:717 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:MULESHOE
Mailing Address - State:TX
Mailing Address - Zip Code:79347-3640
Mailing Address - Country:US
Mailing Address - Phone:806-272-4495
Mailing Address - Fax:806-272-8911
Practice Address - Street 1:717 W 2ND ST
Practice Address - Street 2:
Practice Address - City:MULESHOE
Practice Address - State:TX
Practice Address - Zip Code:79347-3640
Practice Address - Country:US
Practice Address - Phone:806-272-4495
Practice Address - Fax:806-272-8911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-18
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4999207Q00000X, 261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0075DQOtherBCBS OF TEXAS
TX8F5234Medicare PIN
TXI74057Medicare UPIN
TX00X696Medicare Oscar/Certification
TX8J7014Medicare PIN