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General NPI Number Information
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NPI Number | 1780353466
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Entity Type | Organization
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Legal Business Name | LEA D CLIFT
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Dates
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Enumeration Date | 09/07/2021
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Last Update Date | 09/08/2021
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Provider Practice Location Address
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Address Line | 7329 19TH ST
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City | LUBBOCK
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State | TX
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Zip | 79407-4301
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Country | US
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Telephone | 806-392-5216
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Fax |
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Provider Business Mailing Address
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Address Line | 7329 19TH ST
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City | LUBBOCK
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State | TX
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Zip | 79407-4301
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Country | US
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Telephone | 806-392-5216
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LEA CLIFT
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Credential | LSA
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Telephone | 806-392-5216
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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