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General NPI Number Information
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NPI Number | 1770787665
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Entity Type | Organization
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Legal Business Name | CARLOS RIZO-PATRON
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Dates
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Enumeration Date | 06/13/2007
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Last Update Date | 11/19/2010
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Provider Practice Location Address
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Address Line | 3711 22ND ST
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City | LUBBOCK
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State | TX
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Zip | 79410-1303
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Country | US
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Telephone | 806-792-3410
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Fax | 806-799-0533
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Provider Business Mailing Address
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Address Line | PO BOX 94070
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City | LUBBOCK
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State | TX
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Zip | 79493-4070
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Country | US
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Telephone | 806-792-3410
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Fax | 806-799-0533
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Authorized Official
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Title or Position | OWNER
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Name | DR. CARLOS RIZO-PATRON
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Credential | M.D.
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Telephone | 806-792-3410
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | J9303
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License Number State | TX
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