DR. VIVIANE MAMLOK M.D. NPI 1073516993

NPI Information

NPI: 1073516993
Provider Name: DR. VIVIANE MAMLOK, M.D.
Classification: Pathology - 207ZP0213X
Entity Type: Individual

Specialization: Pediatric Pathology

PECOS Registration: Yes

Address:
3601 4TH ST
1A115
LUBBOCK, TX
ZIP 79430
Phone: (806) 743-2155
Get Directions

DR. Viviane Mamlok, M.D. is a pediatric pathology pathology in Lubbock, TX. The provider is a pediatric pathologist is expert in the laboratory diagnosis of diseases that occur during fetal growth, infancy and child development. The practice requires a strong foundation in general pathology and substantial understanding of normal growth and development, along with extensive knowledge of pediatric medicine. DR. Viviane Mamlok, M.D. NPI is 1073516993. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3601 4TH ST
1A115
LUBBOCK, TX
ZIP 79430-002
Phone: (806) 743-2155
Fax: (806) 743-2117

The NPI 1073516993 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/24/2005 and was last updated on 7/12/2007.

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
1	207ZP0101X	Pathology	Anatomic Pathology	H0597	TEXAS	No
2	207ZP0213X	Pathology	Pediatric Pathology	H0597	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	80816Z	OTHER	TEXAS	HMO BLUE
2	E99841	MEDICARE UPIN	TEXAS
3	82P200	MEDICARE ID-TYPE UNSPECIFIED	TEXAS
4	52453	MEDICAID	NEW MEXICO
5	52453	OTHER	NEW MEXICO	PRESBYTERIAN COMMERCIAL
6	J6446	MEDICAID	NEW MEXICO
7	A120	OTHER		TRIWEST
8	82P200	OTHER	TEXAS	BLUE CROSS & BLUE SHIELD

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: 11/14/2023

NPI Synchronization or Removal

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