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:
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Health care specialties

SpecialtyCodeLicense #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 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154307932 NPPES
Texas MEDICAID P000N84V4
Texas Other 110088148
Texas Other 89072S

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