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Individual

HENRY R LEMKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
855 MONTGOMERY ST, FORT WORTH, TX 76107-2553
(817) 735-2900
Mailing address
PO BOX 99335, FORT WORTH, TX 76199-0335
(817) 735-2900

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA01604
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
299618301
TX
01
879N55
BCBS
TX
01
87N147
BCBS
TX
Enumeration date
08/07/2006
Last updated
10/22/2012
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