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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2084D0003X |
Psychiatry & Neurology Specialization: Diagnostic Neuroimaging |
Q8817 | TX | Allopathic & Osteopathic Physicians |
Other Name | Type Code |
---|---|
Texas Tech Neuroimaging Institute | Other Name - Individual/Organization |
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 |
Street Address |
1008 CANTON AVE ROOM 018BF |
City | LUBBOCK |
State | TX |
Zip Code | 79409-3132 |
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 |
Find all providers in zip 79409 |
Taxonomy Code | 2084D0003X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Psychiatry & Neurology |
Specialization | Diagnostic Neuroimaging |
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] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225225568 | Lubbock Neurology, Pllc | Psychiatry & Neurology | 5120 29th Dr, Suite D, Lubbock, TX 79407-2612 | 2007-10-01 |
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 |
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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.