TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER LUBBOCK


Address: 1008 Canton Ave, Room 018bf, Lubbock, TX 79409-3132
Phone: 8067423400

TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER LUBBOCK (NPI# 1164979142) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1164979142
Entity Type Organization
Organization Name TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER LUBBOCK
Other Organization Name TEXAS TECH NEUROIMAGING INSTITUTE
Practice Address 1008 Canton Ave
Room 018bf
Lubbock
TX 79409-3132
Mailing Address Po Box 27476
Salt Lake City
UT 84127-0476
Practice Telephone 8067423400
Mailing Telephone 8067434263
Mailing Fax Number 8067435687
Enumeration Date 2016-09-07
Last Update Date 2019-10-01
Authorized Official Name YAZAN ALDERAZI (FACULTY)
Authorized Official Telephone 8067432391
Authorized Official Credential MD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2084D0003X Psychiatry & Neurology
Specialization: Diagnostic Neuroimaging
Q8817 TX Allopathic & Osteopathic Physicians

Other Provider/Organization Names

Other Name Type Code
Texas Tech Neuroimaging Institute Other Name - Individual/Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1861904898 Texas Tech University Health Sciences Center Lubbock Durable Medical Equipment & Medical Supplies 808 Joliet Ave Unit 210, Lubbock, TX 79415-1158 2017-10-31
1972801223 Texas Tech University Health Sciences Center Lubbock Optometrist 4004 82nd St Bldg 200, Lubbock, TX 79423-1900 2011-03-10
1245289537 Texas Tech University Health Sciences Center Lubbock Orthopaedic Surgery 3601 4th St Fl 4, Lubbock, TX 79430 2006-05-06
1528621240 Texas Tech University Health Sciences Center Lubbock Counselor 3601 4th St, Suite 3b302, Lubbock, TX 79430-6225 2019-04-18
1932611969 Texas Tech University Health Sciences Center Lubbock Durable Medical Equipment & Medical Supplies 4102 24th St Ste 507, Lubbock, TX 79410-1805 2017-10-31
1336369669 Texas Tech University Health Sciences Center Lubbock Clinic/Center 3601 4th St, Lubbock, TX 79430-0002 2007-04-27
1053458026 Texas Tech University Health Sciences Center Lubbock Clinic/Center 3601 4th St, Ste 2a100, Lubbock, TX 79430-0002 2007-01-31
1538239769 Texas Tech University Health Sciences Center Lubbock Clinic/Center 3601 4th St, Lubbock, TX 79430-0002 2006-11-08
1548219827 Texas Tech University Health Sciences Center Lubbock Clinic/Center 3601 4th St, Ste 4a100, Lubbock, TX 79430-0002 2006-05-06
1184673469 Texas Tech University Health Sciences Center Lubbock Nurse Anesthetist, Certified Registered 3601 4th St, Ste 1b350k, Lubbock, TX 79430-0002 2006-05-06

Office Location

Street Address 1008 CANTON AVE
ROOM 018BF
City LUBBOCK
State TX
Zip Code 79409-3132

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1841828126 Luke Malone Student in an Organized Health Care Education/Training Program 2503 Mac Davis Lane, Lubbock, TX 79409 2020-03-31
1023563889 Austin P. Wade Psychologist 1003 Flint Ave, Lubbock, TX 79409 2016-08-23
1104221928 Amanda Dorsten Specialist/Technologist 6216 66th St, Lubbock, TX 79409 2014-10-23
1124420427 Chrystal Jansz Behavioral Analyst 2902 18th Street, Lubbock, TX 79409 2014-09-18
1205044740 Texas Tech University Psychology Clinic Psychologist 18th Street and Boston Avenue, Lubbock, TX 79409 2007-05-18
1578682175 Stephen Michael Pincock Specialist/Technologist 6th & Red Raider Ave., Atf Box 43021, Lubbock, TX 79409 2007-03-28
1871636738 Texas Tech Student Health Pharmacy Pharmacy 1003 Flint Ave., Lubbock, TX 79409 2007-02-14
1871996421 Jason C Cohen Behavioral Analyst 2902 18th Street, Lubbock, TX 79409 2014-09-26
1710389317 Texas Tech University Behavioral Analyst 2902 18th Street, Lubbock, TX 79409 2014-09-25
1215339452 Wesley H Dotson Behavioral Analyst 2902 18th Street, Lubbock, TX 79409 2014-09-18
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Taxonomy Information

Taxonomy Code 2084D0003X
Grouping Allopathic & Osteopathic Physicians
Classification Psychiatry & Neurology
Specialization Diagnostic Neuroimaging

Taxonomy Definition

A licensed physician, who has completed a residency program in Neurology, and who has additional training, experience, and competence in the standards of performance and interpretation of Magnetic Resonance Imaging (MRI / MRA) of the head, spine, and peripheral nerves, and Computed Tomography (CT) of the head and spine. Physicians are trained in the administration of contrast media and the recognition and treatment of adverse reactions to contrast media. Neuroimaging training encompasses thorough knowledge of clinical neurology, neurophysiology, neuroanatomy, neurochemistry, neuropharmacology, and dynamics of cerebrospinal fluid circulation. Physicians possess special expertise in the technical aspects and clinical applications of each of the modalities and techniques of neuroimaging.
Notes: Source: American Academy of Neurology, www.aan.com [1/1/2007: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1225225568 Lubbock Neurology, Pllc Psychiatry & Neurology 5120 29th Dr, Suite D, Lubbock, TX 79407-2612 2007-10-01

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1366062242 Veronica Trejo Mata Psychiatry & Neurology 305 N Collier St, Grand Saline, TX 75140-1403 2020-04-21
1881236644 Polaris Eeg and Diagnostics Psychiatry & Neurology 6700 Woodlands Pkwy Ste 200, The Woodlands, TX 77382-2577 2019-10-14
1134659709 Mission Diagnostics LLC Psychiatry & Neurology 24165 Ih-10 West Ste 217, Pmb #717, San Antonio, TX 78257-1160 2017-06-15
1184924219 Apogee Diagnostics, Pa Psychiatry & Neurology 12337 Jones Road, Suite 427, Houston, TX 77070 2010-10-22
1013554641 Crown Diagnostics, LLC Psychiatry & Neurology 2918 San Jacinto St Ste 150, Houston, TX 77004-2708 2019-12-02
1083141691 One Care Monitoring, LLC Psychiatry & Neurology 5080 Spectrum Dr Ste 1100e, Addison, TX 75001-4688 2017-05-12
1619114915 Burket Businesses, LLC Psychiatry & Neurology 341 E Parkwood Ave, Friendswood, TX 77546-5147 2009-01-08
1104077031 Family Psychiatry Psychiatry & Neurology 341 E Parkwood Ave, Friendswood, TX 77546-5147 2008-10-09

Competitor

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City LUBBOCK
Zip Code 79409

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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