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General NPI Number Information
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NPI Number | 1215983788
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Entity Type | Organization
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Legal Business Name | THOMAS F. NEAL, M.D., STAN E. POTOCKI, M.D., PROFESSIONAL ASSOCIATION
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 10/30/2014
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Provider Practice Location Address
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Address Line | 3621 22ND ST STE 300
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City | LUBBOCK
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State | TX
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Zip | 79410-1301
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Country | US
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Telephone | 806-792-5331
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Fax | 806-792-9417
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Provider Business Mailing Address
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Address Line | 3621 22ND ST STE 300
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City | LUBBOCK
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State | TX
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Zip | 79410-1301
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Country | US
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Telephone | 806-792-5331
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Fax | 806-792-9417
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Authorized Official
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Title or Position | OWNER
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Name | STAN E POTOCKI
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Credential | M.D.
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Telephone | 806-792-5331
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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