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General NPI Number Information
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NPI Number | 1952985285
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Entity Type | Organization
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Legal Business Name | LUBBOCK PSYCHIATRY, PLLC.
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Dates
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Enumeration Date | 05/12/2021
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Last Update Date | 01/25/2023
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Provider Practice Location Address
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Address Line | 5416 114TH ST, SUITE 100
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City | LUBBOCK
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State | TX
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Zip | 79424-5731
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Country | US
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Telephone | 806-785-1611
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Fax |
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Provider Business Mailing Address
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Address Line | 5416 114TH ST SUITE 100
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City | LUBBOCK
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State | TX
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Zip | 79424-7690
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Country | US
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Telephone | 806-544-0446
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Fax |
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | BRADLEY NELSON
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Credential |
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Telephone | 806-544-0446
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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