Healthcare Provider Details

I. General information

NPI: 1588683478
Provider Name (Legal Business Name): KY RIGGINS LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W VETERANS BLVD
BIG SPRING TX
79720-5566
US

IV. Provider business mailing address

2908 COUNTY ROAD O
LAMESA TX
79331-5924
US

V. Phone/Fax

Practice location:
  • Phone: 432-263-7361
  • Fax: 432-268-5086
Mailing address:
  • Phone: 806-462-7335
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number38371
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: