Healthcare Provider Details

I. General information

NPI: 1588309371
Provider Name (Legal Business Name): KUI MEDICAL SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2022
Last Update Date: 08/14/2024
Certification Date: 08/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4005 136TH ST
LUBBOCK TX
79423-2741
US

IV. Provider business mailing address

PO BOX 64454
LUBBOCK TX
79464-4454
US

V. Phone/Fax

Practice location:
  • Phone: 972-754-9810
  • Fax:
Mailing address:
  • Phone: 972-754-9810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: KENNETH IWUJI
Title or Position: OWNER
Credential: MD
Phone: 972-754-9810