Healthcare Provider Details

I. General information

NPI: 1730147315
Provider Name (Legal Business Name): JUSTIN HAROLD MCCARTHY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 12/13/2022
Certification Date: 12/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7202 SLIDE RD STE 100
LUBBOCK TX
79424-2555
US

IV. Provider business mailing address

7202 SLIDE RD STE 100
LUBBOCK TX
79424-2555
US

V. Phone/Fax

Practice location:
  • Phone: 806-761-0722
  • Fax: 806-797-1265
Mailing address:
  • Phone: 806-761-0722
  • Fax: 806-797-1265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberH7368
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: