Healthcare Provider Details

I. General information

NPI: 1871595231
Provider Name (Legal Business Name): PULMONARY ASSOCIATES OF LUBBOCK LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2005
Last Update Date: 12/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3621 22ND ST. SUITE 300
LUBBOCK TX
79410-1302
US

IV. Provider business mailing address

3621 22ND ST. SUITE 300
LUBBOCK TX
79410-1302
US

V. Phone/Fax

Practice location:
  • Phone: 806-762-8066
  • Fax: 806-791-8498
Mailing address:
  • Phone: 806-762-8066
  • Fax: 806-791-8499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. MARSHA STANLEY
Title or Position: BUSINESS OFFICE
Credential:
Phone: 806-791-8484