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General NPI Number Information
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NPI Number | 1225225568
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Entity Type | Organization
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Legal Business Name | LUBBOCK NEUROLOGY, PLLC
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Dates
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Enumeration Date | 10/01/2007
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Last Update Date | 10/01/2007
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Provider Practice Location Address
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Address Line | 5120 29TH DR SUITE D
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City | LUBBOCK
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State | TX
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Zip | 79407-2612
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Country | US
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Telephone | 806-281-9999
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Fax | 806-281-9900
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Provider Business Mailing Address
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Address Line | 5120 29TH DR SUITE D
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City | LUBBOCK
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State | TX
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Zip | 79407-2612
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Country | US
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Telephone | 806-281-9999
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Fax | 806-281-9900
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. CHERYL LYNN D'CRUZ
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Credential |
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Telephone | 806-281-9999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084D0003X
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Taxonomy Name | Diagnostic Neuroimaging (Psychiatry & Neurology) Physician
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License Number | L0113
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2084S0012X
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Taxonomy Name | Sleep Medicine (Psychiatry & Neurology) Physician
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License Number | L0113
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | L0113
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License Number State | TX
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