Healthcare Provider Details

I. General information

NPI: 1770516775
Provider Name (Legal Business Name): RICHARD A PARTIN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 04/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

517 82ND ST
LUBBOCK TX
79404-6337
US

IV. Provider business mailing address

PO BOX 3987
LUBBOCK TX
79452-3987
US

V. Phone/Fax

Practice location:
  • Phone: 806-745-2551
  • Fax: 806-745-5171
Mailing address:
  • Phone: 806-745-2551
  • Fax: 806-745-5171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number0034595
License Number StateTX

VIII. Authorized Official

Name: MR. BOBBY ROYCE LOGAN
Title or Position: MANAGER
Credential: RRT-NPS/RPSGT
Phone: 806-745-2551