Healthcare Provider Details

I. General information

NPI: 1972604585
Provider Name (Legal Business Name): MILTON M. ROWLEY M.D., PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 09/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3519 22ND PL
LUBBOCK TX
79410-1315
US

IV. Provider business mailing address

3519 22ND PL
LUBBOCK TX
79410-1315
US

V. Phone/Fax

Practice location:
  • Phone: 806-792-3715
  • Fax: 806-792-1645
Mailing address:
  • Phone: 806-792-3715
  • Fax: 806-792-1645

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MILTON M. ROWLEY
Title or Position: OFFICER
Credential: M.D.
Phone: 806-792-3715