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General NPI Number Information
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NPI Number | 1538239769
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Entity Type | Organization
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Legal Business Name | TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER LUBBOCK
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 10/01/2019
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Provider Practice Location Address
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Address Line | 3601 4TH ST
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City | LUBBOCK
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State | TX
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Zip | 79430-0002
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Country | US
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Telephone | 806-743-2475
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Fax | 806-743-2478
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Provider Business Mailing Address
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Address Line | PO BOX 27476
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City | SALT LAKE CITY
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State | UT
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Zip | 84127-0476
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Country | US
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Telephone | 806-743-4263
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Fax | 806-743-2787
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Authorized Official
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Title or Position | ASSISTANT DEAN OF FINANCE ADMIN
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Name | BRENT MAJORS
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Credential |
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Telephone | 806-743-1830
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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