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NPI Code Detail

MEDICARE: SOUTH PLAINS RURAL HEALTH SERVICES INC

MEDICARE: SOUTH PLAINS RURAL HEALTH SERVICES INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry

General Provider Information

NPI Number : 1093828923
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTH PLAINS RURAL HEALTH SERVICES INC
Provider Business Mailing Address
First Line : 1000 FARM MARKET RD 300
Second Line :
City : LEVELLAND
State : TX
Zip : 79336-6235
Country : US
Telephone Number : 806-897-1987
Fax Number : 806-894-3378
Provider Business Practice Location Address
First Line : 1000 FARM MARKET RD 300
Second Line :
City : LEVELLAND
State : TX
Zip : 79336-6235
Country : US
Telephone Number : 806-897-1987
Fax Number : 806-894-3378
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : DR. JUDITH MADURA
Credential : M.D.
Telephone Number : 806-897-1987
Provider Enumeration Date : 08/16/2006
Last Update Date : 08/22/2020

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1295746402 — SOUTH PLAINS RURAL HEALTH SERVICES, INC.
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1285747113 — SOUTH PLAINS RURAL HEALTH SERVICES INC
Practice Location Address:
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LEVELLAND, TX
79336-6235
Practice Phone: 806-897-1987
Practice Fax: 806-894-3378

Directions to “SOUTH PLAINS RURAL HEALTH SERVICES INC ” Practice Location

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