Healthcare Provider Details

I. General information

NPI: 1396700134
Provider Name (Legal Business Name): NARAYAN LAXMAN HEGDE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2006
Last Update Date: 10/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3420 22ND PLACE
LUBBOCK TX
79410
US

IV. Provider business mailing address

3420 22ND PLACE
LUBBOCK TX
79410
US

V. Phone/Fax

Practice location:
  • Phone: 806-725-1800
  • Fax: 806-723-6532
Mailing address:
  • Phone: 806-725-7800
  • Fax: 806-723-6532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberF3165
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: