Basic Information
Provider Information
NPI: 1437353000
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LIPP
FirstName: ADAM
MiddleName: SOLOMON
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 840853
Address2:  
City: DALLAS
State: TX
PostalCode: 752841019
CountryCode: US
TelephoneNumber: 9722331999
FaxNumber: 9722333666
Practice Location
Address1: 3705 MEDICAL PKWY
Address2: SUITE 570
City: AUSTIN
State: TX
PostalCode: 787051019
CountryCode: US
TelephoneNumber: 5124542554
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/14/2007
LastUpdateDate: 09/23/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/23/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RA0000XBP10026753TXN Allopathic & Osteopathic PhysiciansInternal MedicineAdolescent Medicine
207L00000XN5810TXY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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