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LATE BLOOMERS LLC NPI 1073270724


NPI Information

NPI: 1073270724
Provider Name: LATE BLOOMERS, LLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 45D2242666

Address:
1801 W. LOOP 281
LONGVIEW, TX
ZIP 75604
Phone: (903) 804-4642
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LATE BLOOMERS, LLC is a family medicine in Longview, TX. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. LATE BLOOMERS, LLC NPI is 1073270724. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1801 W. LOOP 281
LONGVIEW, TX
ZIP 75604
Phone: (903) 804-4642
Fax: (903) 295-6764

The provider's authorized official is Christohper M Burling .
The authorized official title is Physician and has the following contact phone number (903) 575-9500.

The CLIA number assigned to this NPI record is 45D2242666 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/17/2021 and was last updated on 11/17/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207P00000XEmergency MedicineNo
2363A00000XPhysician AssistantNo
3363LA2100XNurse PractitionerAcute CareNo
4363LF0000XNurse PractitionerFamilyNo
5207Q00000XFamily MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.