Healthcare Provider Details

I. General information

NPI: 1114336898
Provider Name (Legal Business Name): SEXTON ENTERPRISES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2014
Last Update Date: 08/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2307 ERSKINE ST
LUBBOCK TX
79415-2007
US

IV. Provider business mailing address

2307 ERSKINE ST
LUBBOCK TX
79415-2007
US

V. Phone/Fax

Practice location:
  • Phone: 806-765-5456
  • Fax: 806-765-7475
Mailing address:
  • Phone: 806-765-5456
  • Fax: 806-765-7475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number StateTX

VIII. Authorized Official

Name: RHONDA GLASS
Title or Position: GENERAL MANAGER
Credential:
Phone: 806-765-5456