Lilly, Theodore J
Lilly, Theodore J is an individual health care provider with primary practice located at 434 S.W. Wilshire , Burleson TX 76028-5330. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Lilly, Theodore J can be contacted via phone (817) 447-1208.Contact Information
Primary practice address
434 S.W. Wilshire
Burleson TX 76028-5330
Phone: (817) 447-1208
Fax: (817) 447-1106
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | G9146 | Texas |
Profile Details
| NPI number | 1154307932 |
|---|---|
| LBN Legal business name | Lilly, Theodore J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 22nd, 2005 |
| Last updated | Sep 2nd, 2008 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154307932 | NPPES |
| Texas | MEDICAID | P000N84V4 | |
| Texas | Other | 110088148 | |
| Texas | Other | 89072S |
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