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NPI Code Detail

MEDICARE: PHYSICIAN NETWORK SERVICES

MEDICARE: PHYSICIAN NETWORK SERVICES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1619136488
Entity Type Code : Organization
Provider Name (Legal Business Name) : PHYSICIAN NETWORK SERVICES
Provider Business Mailing Address
First Line : 5219 CITY BANK PKWY
Second Line : STE 135
City : LUBBOCK
State : TX
Zip : 79407-3544
Country : US
Telephone Number : 806-761-0333
Fax Number : 806-722-2908
Provider Business Practice Location Address
First Line : 5219 CITY BANK PKWY
Second Line : STE 135
City : LUBBOCK
State : TX
Zip : 79407-3544
Country : US
Telephone Number : 806-761-0333
Fax Number : 806-722-2908
Authorized Official
Title or Position : ENROLLMENT SPECIALIST
Name : KENDRA L MASSEY
Credential :
Telephone Number : 806-761-0333
Provider Enumeration Date : 06/05/2008
Last Update Date : 06/05/2008

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Directions to “PHYSICIAN NETWORK SERVICES ” Practice Location

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