Basic Information
| Provider Information | |||||||||
| NPI: | 1770826984 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | POSTELL | ||||||||
| FirstName: | LONETTA | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 FORD PLACE | ||||||||
| Address2: | 4B | ||||||||
| City: | DETROIT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 482022177 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3139162088 | ||||||||
| FaxNumber: | 3139161630 | ||||||||
| Practice Location | |||||||||
| Address1: | 3166 S STATE HIGHWAY 161 STE 170 | ||||||||
| Address2: | |||||||||
| City: | GRAND PRAIRIE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750527720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9726400005 | ||||||||
| FaxNumber: | 2103145044 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/05/2013 | ||||||||
| LastUpdateDate: | 09/08/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/08/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 4301103317 | MI | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | T9474 | TX | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.