Healthcare Provider Details
I. General information
NPI: 1235465741
Provider Name (Legal Business Name): PATRICIA R. ARLEDGE, MD, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/19/2009
Last Update Date: 10/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3502 9TH ST SUITE 270
LUBBOCK TX
79415-3300
US
IV. Provider business mailing address
3502 9TH ST SUITE 270
LUBBOCK TX
79415-3300
US
V. Phone/Fax
- Phone: 806-788-5598
- Fax:
- Phone: 806-788-5598
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208200000X |
| Taxonomy | Plastic Surgery Physician |
| License Number | K9992 |
| License Number State | TX |
VIII. Authorized Official
Name: DR.
PATRICIA
R.
ARLEDGE
Title or Position: MANAGING MEMBER
Credential: M.D.
Phone: 806-535-4886