=====================================================
General NPI Number Information
=====================================================
NPI Number | 1174198832
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TOMBS FAMILY HOLDINGS, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/25/2021
-----------------------------------------------------
Last Update Date | 06/09/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3814 24TH ST
-----------------------------------------------------
City | LUBBOCK
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79410-1814
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 806-701-2639
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3814 24TH ST
-----------------------------------------------------
City | LUBBOCK
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79410-1814
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 806-701-2639
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/ADMINISTRATOR & DIRECTOR
-----------------------------------------------------
Name | ELIZABETH TOMBS
-----------------------------------------------------
Credential | CNM
-----------------------------------------------------
Telephone | 806-701-2639
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 367A00000X
-----------------------------------------------------
Taxonomy Name | Advanced Practice Midwife
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------