Individual
LYNN R COPELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
111 VISION PARK BLVD, SUITE 150, SHENANDOAH, TX 77384-3002
(936) 321-0033
(936) 321-0032
Mailing address
PO BOX 130894, THE WOODLANDS, TX 77393-0894
(936) 321-0033
(936) 321-0032
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
J0464
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115811504
—
TX
05
—
115811506
—
TX
01
—
35698
AMERICAID
TX
01
—
3740661
CIGNA
TX
01
—
4573693
AETNA
TX
01
—
811119
AETNA
TX
01
—
84440Y
BLUE CROSS
TX
Enumeration date
08/02/2005
Last updated
05/20/2008
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