MEDICARE: TERRICK PROPERTIES 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
1	314000000X	Skilled Nursing Facility	113881	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588667604
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TERRICK PROPERTIES INC

Provider Business Mailing Address
First Line	:	4320 W 19TH ST
Second Line	:
City	:	LUBBOCK
State	:	TX
Zip	:	79407-2407
Country	:	US
Telephone Number	:	806-795-1774
Fax Number	:	806-795-4652

Provider Business Practice Location Address
First Line	:	4320 W 19TH ST
Second Line	:
City	:	LUBBOCK
State	:	TX
Zip	:	79407-2407
Country	:	US
Telephone Number	:	806-795-1774
Fax Number	:	806-795-4652

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. RICHARD RUBLE
Credential	:
Telephone Number	:	806-780-7000

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	07/15/2010

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Directions to “TERRICK PROPERTIES INC ” Practice Location

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