Healthcare Provider Details

I. General information

NPI: 1730985425
Provider Name (Legal Business Name): ALEJANDRO VERDUGO MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2025
Last Update Date: 02/22/2025
Certification Date: 02/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9826 SLIDE RD
LUBBOCK TX
79424-5781
US

IV. Provider business mailing address

9826 SLIDE RD
LUBBOCK TX
79424-5781
US

V. Phone/Fax

Practice location:
  • Phone: 281-221-9964
  • Fax:
Mailing address:
  • Phone: 281-221-9964
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: ALEJANDRO VERDUGO
Title or Position: OWNER
Credential: MD
Phone: 281-221-7330