Healthcare Provider Details

I. General information

NPI: 1699876201
Provider Name (Legal Business Name): PATRICIA R. ARLEDGE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 01/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3502 9TH ST. SUITE 270
LUBBOCK TX
79415
US

IV. Provider business mailing address

3502 9TH ST. SUITE 270
LUBBOCK TX
79415
US

V. Phone/Fax

Practice location:
  • Phone: 806-788-5598
  • Fax: 806-788-0598
Mailing address:
  • Phone: 806-788-5598
  • Fax: 806-788-0598

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberK9992
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: