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General NPI Number Information
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NPI Number | 1588997225
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Entity Type | Organization
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Legal Business Name | CONSULTANTS IN INFECTIOUS DISEASES
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Dates
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Enumeration Date | 09/14/2009
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Last Update Date | 09/14/2009
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Provider Practice Location Address
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Address Line | 4404 19TH ST STE. C
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City | LUBBOCK
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State | TX
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Zip | 79407-2424
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Country | US
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Telephone | 806-795-8150
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Fax | 806-791-6688
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Provider Business Mailing Address
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Address Line | PO BOX 16327
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City | LUBBOCK
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State | TX
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Zip | 79490-6327
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Country | US
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Telephone | 806-795-8150
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Fax | 806-791-6688
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | TONI ANN CLINE
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Credential | PA-C
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Telephone | 806-795-8150
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number | 15037
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License Number State | TX
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