DR. VIVIANE MAMLOK (NPI# 1073516993) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073516993 |
| Entity Type | Individual |
| Full Name | DR. VIVIANE MAMLOK |
| Credential | M.D. |
| Practice Address |
3601 4th St 1a115 Lubbock TX 79430-0002 |
| Mailing Address |
Po Box 5865 Lubbock TX 79408-5865 |
| Practice Telephone | 8067432155 |
| Practice Fax Number | 8067432117 |
| Mailing Telephone | 8067432898 |
| Mailing Fax Number | 8067433596 |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2007-07-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207ZP0101X |
Pathology Specialization: Anatomic Pathology |
H0597 | TX | Allopathic & Osteopathic Physicians |
| Y | 207ZP0213X |
Pathology Specialization: Pediatric Pathology |
H0597 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TRIWEST | A120 | 01 | |
| TX | HMO BLUE | 80816Z | 01 |
| NM | PRESBYTERIAN COMMERCIAL | 52453 | 01 |
| NM | 52453 | 05 | |
| TX | BLUE CROSS & BLUE SHIELD | 82P200 | 01 |
| NM | J6446 | 05 |
| Street Address |
3601 4TH ST 1A115 |
| City | LUBBOCK |
| State | TX |
| Zip Code | 79430-0002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104436252 | Kanak N/a Parmar | Student in an Organized Health Care Education/Training Program | 3601 4th St, Lubbock, TX 79430-0002 | 2020-08-04 |
| 1407465115 | Donald Wayne King Jr. | Nurse Anesthetist, Certified Registered | 3601 4th St, Lubbock, TX 79430-0002 | 2020-07-28 |
| 1588288674 | Hillary Powers | Student in an Organized Health Care Education/Training Program | 3601 4th St, Lubbock, TX 79430-0002 | 2020-06-03 |
| 1215551692 | Amanda R Edinger | Student in an Organized Health Care Education/Training Program | 3601 4th St, Lubbock, TX 79430-0002 | 2020-06-02 |
| 1487278966 | Daniel Elling Brown | Student in an Organized Health Care Education/Training Program | 3601 4th St, Lubbock, TX 79430-6211 | 2020-06-01 |
| 1588288013 | Fabiana Monte Alegre Olmos Fernandez | Student in an Organized Health Care Education/Training Program | 3601 4th St, Lubbock, TX 79430-0002 | 2020-06-01 |
| 1154945574 | Alex Wilkins | Student in an Organized Health Care Education/Training Program | 3601 4th St, Lubbock, TX 79430-0002 | 2020-06-01 |
| 1720602253 | Amanda Lee Huggett | Student in an Organized Health Care Education/Training Program | 3601 4th St, Lubbock, TX 79430-0002 | 2020-06-01 |
| 1609490192 | Zeyad Saeed Amr Elharabi | Student in an Organized Health Care Education/Training Program | 3601 4th St, Department of Internal Medicine, Lubbock, TX 79430-0002 | 2020-06-01 |
| 1962026377 | Cheyene Nicole Bownds | Student in an Organized Health Care Education/Training Program | 3601 4th St, Lubbock, TX 79430-0002 | 2020-06-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730702473 | Emily Bouffard | Student in an Organized Health Care Education/Training Program | 3601 4th Street Mail Stop 8143, Lubbock, TX 79430 | 2020-05-27 |
| 1891350310 | Erin Leigh Burton | Student in an Organized Health Care Education/Training Program | 3601 Fourth Street, Department of Surgery Ms 8312, Lubbock, TX 79430 | 2019-05-09 |
| 1851861439 | Zachery Brian Sneed | Counselor | 3b310, 3601 4th St Stop 6225, Lubbock, TX 79430 | 2018-11-27 |
| 1831683481 | Swagat Parajulee | Student in an Organized Health Care Education/Training Program | 3601 4th St., Stop 9410, Office 4b076, Lubbock, TX 79430 | 2018-06-18 |
| 1649711904 | William David Boothe Jr. | Dermatology | 3601 4th St Stop 6211, Lubbock, TX 79430 | 2017-03-19 |
| 1982144945 | Kazutaka Araki | Specialist/Technologist | 3601, 4th St, Lubbock, TX 79430 | 2017-02-24 |
| 1659725125 | Thomas Gregory Wyatt | Student in an Organized Health Care Education/Training Program | 3601 4th St Rm 3a122b, Lubbock, TX 79430 | 2016-04-20 |
| 1619391760 | Chinyere Mbagwu | General Practice | 3601 4th St # Ms 8143, Lubbock, TX 79430 | 2014-02-10 |
| 1982044111 | Eileen Mary Sprys | Family Medicine | 3601 4th St., Stop 8143, Lubbock, TX 79430 | 2013-07-02 |
| 1205196243 | Hilmi Alam | Family Medicine | Department of Family & Community Medicine, 3601 4th Street, Stop 8143, Lubbock, TX 79430 | 2012-05-24 |
| Find all providers in zip 79430 | ||||
| Taxonomy Code | 207ZP0213X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Pediatric Pathology |
| 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. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780234229 | Morgan Mayeux | Pathology | 3560 Delaware St, Beaumont, TX 77706-3067 | 2019-09-17 |
| 1326228941 | Irene Castaneda-sanchez | Pathology | 801 7th Ave, Fort Worth, TX 76104-2733 | 2007-11-12 |
| 1831246628 | Yvette B Dzurik | Pathology | 801 7th Ave, Fort Worth, TX 76104-2733 | 2007-01-04 |
| 1083771919 | Anita Louise Sengupta | Pathology | 1935 Medical District Dr, Cmc Dallas, Department of Pathology, Dallas, TX 75235-7701 | 2007-01-02 |
| 1659474633 | Hal Kenneth Hawkins | Pathology | 815 Market St, Pathology, Galveston, TX 77550-2725 | 2006-09-06 |
| 1962504134 | Carlos A Galliani | Pathology | 801 7th Ave, Fort Worth, TX 76104-2733 | 2006-09-01 |
| 1063424919 | Ajit J Alles | Pathology | 801 7th Ave, Fort Worth, TX 76104-2733 | 2006-08-12 |
| 1023027554 | Dinesh Rakheja | Pathology | 5323 Harry Hines Blvd, Dallas, TX 75390-7208 | 2006-08-05 |
| 1801856257 | Arthur George Weinberg | Pathology | 5323 Harry Hines Blvd, Dallas, TX 75390-7208 | 2006-03-27 |
| 1467412155 | Thomas Milligan | Pathology | 3533 S Alameda St, Corpus Christi, TX 78411-1721 | 2006-03-25 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.