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General NPI Number Information
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NPI Number | 1235686015
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Entity Type | Organization
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Legal Business Name | KING L BUCHANAN JR PHD PC
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Dates
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Enumeration Date | 09/08/2016
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Last Update Date | 09/08/2016
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Provider Practice Location Address
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Address Line | 8008 SLIDE RD SUITE #25
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City | LUBBOCK
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State | TX
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Zip | 79424-2841
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Country | US
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Telephone | 806-632-7955
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Fax | 806-794-8458
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Provider Business Mailing Address
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Address Line | 8008 SLIDE RD SUITE #25
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City | LUBBOCK
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State | TX
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Zip | 79424-2841
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Country | US
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Telephone | 806-632-7955
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Fax | 806-794-8458
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Authorized Official
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Title or Position | OWNER
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Name | DR. KING BUCHANAN II
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Credential | PH.D.
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Telephone | 806-632-7955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 23833
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License Number State | TX
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