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General NPI Number Information
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NPI Number | 1093025447
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Entity Type | Organization
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Legal Business Name | CHERYL C. LANDRY, MD PA
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Dates
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Enumeration Date | 10/19/2010
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Last Update Date | 10/19/2010
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Provider Practice Location Address
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Address Line | 5215 96TH ST
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City | LUBBOCK
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State | TX
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Zip | 79424-4413
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Country | US
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Telephone | 806-780-6868
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Fax | 806-780-2065
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Provider Business Mailing Address
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Address Line | 5215 96TH ST
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City | LUBBOCK
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State | TX
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Zip | 79424-4413
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Country | US
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Telephone | 806-780-6868
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Fax | 806-780-2065
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | CHERYL C LANDRY
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Credential | M.D.
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Telephone | 806-780-6060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number | J6533
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License Number State | TX
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