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General NPI Number Information
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NPI Number | 1184695538
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Entity Type | Individual
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Provider Name | JOHNNY A QUBTY MEDICAL DOCTOR
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Gender | Male
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Dates
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Enumeration Date | 02/01/2006
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Last Update Date | 11/15/2007
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Provider Practice Location Address
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Address Line | 3601 21ST ST SUITE 3-A
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City | LUBBOCK
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State | TX
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Zip | 79410-1229
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Country | US
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Telephone | 806-771-7877
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Fax | 806-771-7474
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Provider Business Mailing Address
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Address Line | 3601 21ST ST SUITE 3-A
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City | LUBBOCK
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State | TX
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Zip | 79410-1229
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Country | US
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Telephone | 806-771-7877
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Fax | 806-771-7474
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | H2703
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License Number State | TX
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