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General NPI Number Information
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NPI Number | 1144013749
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Entity Type | Organization
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Legal Business Name | CAPROCK NEONATOLOGY
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Dates
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Enumeration Date | 05/27/2025
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 4015 22ND PL
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City | LUBBOCK
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State | TX
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Zip | 79410-1119
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Country | US
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Telephone | 806-725-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 6803 78TH ST
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City | LUBBOCK
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State | TX
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Zip | 79424-0748
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Country | US
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Telephone | 806-441-8545
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JACOB PELTZMAN
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Credential |
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Telephone | 856-470-4776
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number |
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License Number State |
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