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General NPI Number Information
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NPI Number | 1033272497
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Entity Type | Organization
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Legal Business Name | COVENANT HEALTH SYSTEM
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 07/11/2025
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Provider Practice Location Address
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Address Line | 4000 22ND PL
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City | LUBBOCK
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State | TX
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Zip | 79410-1894
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Country | US
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Telephone | 806-725-1011
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Fax |
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Provider Business Mailing Address
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Address Line | 1801 LIND AVE SW # 9016
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City | RENTON
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State | WA
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Zip | 98057-3368
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ASSISTANT SECRETARY OF ENROLLMENTS
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Name | DONALD WAYNE ANDERSON JR.
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Credential |
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Telephone | 425-358-9786
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | 000465
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License Number State | TX
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