DR. KENN ALAN FREEDMAN (NPI# 1235120353) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235120353 |
| Entity Type | Individual |
| Full Name | DR. KENN ALAN FREEDMAN |
| Credential | M.D. |
| Practice Address |
3601 4th St 2a100 Lubbock TX 79430-0002 |
| Mailing Address |
Po Box 5865 Lubbock TX 79408-5865 |
| Practice Telephone | 8067432020 |
| Practice Fax Number | 8067431782 |
| Mailing Telephone | 8067432898 |
| Mailing Fax Number | 8067432787 |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2014-01-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | H8052 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 100890602 | 05 | |
| OK | 100211700A | 05 | |
| TX | FIRSTCARE COMMERCIAL | 113026100 | 01 |
| TX | BC/BS | 86941X | 01 |
| NM | B3415 | 05 | |
| NM | TRIWEST | E002 | 01 |
| TX | 100890601 | 05 | |
| TX | HMO BLUE | 84332Z | 01 |
| TX | 113026102 | 05 | |
| TX | PRESBYTERIAN COMMERCIAL | 64022 | 01 |
| NM | 64022 | 05 |
| Street Address |
3601 4TH ST 2A100 |
| City | LUBBOCK |
| State | TX |
| Zip Code | 79430-0002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073516993 | Viviane Mamlok | Pathology | 3601 4th St, 1a115, Lubbock, TX 79430-0002 | 2005-05-24 |
| 1104436252 | Kanak N/a Parmar | Student in an Organized Health Care Education/Training Program | 3601 4th St, Lubbock, TX 79430-0002 | 2020-08-04 |
| 1407465115 | Donald Wayne King Jr. | Nurse Anesthetist, Certified Registered | 3601 4th St, Lubbock, TX 79430-0002 | 2020-07-28 |
| 1588288674 | Hillary Powers | Student in an Organized Health Care Education/Training Program | 3601 4th St, Lubbock, TX 79430-0002 | 2020-06-03 |
| 1215551692 | Amanda R Edinger | Student in an Organized Health Care Education/Training Program | 3601 4th St, Lubbock, TX 79430-0002 | 2020-06-02 |
| 1487278966 | Daniel Elling Brown | Student in an Organized Health Care Education/Training Program | 3601 4th St, Lubbock, TX 79430-6211 | 2020-06-01 |
| 1588288013 | Fabiana Monte Alegre Olmos Fernandez | Student in an Organized Health Care Education/Training Program | 3601 4th St, Lubbock, TX 79430-0002 | 2020-06-01 |
| 1154945574 | Alex Wilkins | Student in an Organized Health Care Education/Training Program | 3601 4th St, Lubbock, TX 79430-0002 | 2020-06-01 |
| 1720602253 | Amanda Lee Huggett | Student in an Organized Health Care Education/Training Program | 3601 4th St, Lubbock, TX 79430-0002 | 2020-06-01 |
| 1609490192 | Zeyad Saeed Amr Elharabi | Student in an Organized Health Care Education/Training Program | 3601 4th St, Department of Internal Medicine, Lubbock, TX 79430-0002 | 2020-06-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730702473 | Emily Bouffard | Student in an Organized Health Care Education/Training Program | 3601 4th Street Mail Stop 8143, Lubbock, TX 79430 | 2020-05-27 |
| 1891350310 | Erin Leigh Burton | Student in an Organized Health Care Education/Training Program | 3601 Fourth Street, Department of Surgery Ms 8312, Lubbock, TX 79430 | 2019-05-09 |
| 1851861439 | Zachery Brian Sneed | Counselor | 3b310, 3601 4th St Stop 6225, Lubbock, TX 79430 | 2018-11-27 |
| 1831683481 | Swagat Parajulee | Student in an Organized Health Care Education/Training Program | 3601 4th St., Stop 9410, Office 4b076, Lubbock, TX 79430 | 2018-06-18 |
| 1649711904 | William David Boothe Jr. | Dermatology | 3601 4th St Stop 6211, Lubbock, TX 79430 | 2017-03-19 |
| 1982144945 | Kazutaka Araki | Specialist/Technologist | 3601, 4th St, Lubbock, TX 79430 | 2017-02-24 |
| 1659725125 | Thomas Gregory Wyatt | Student in an Organized Health Care Education/Training Program | 3601 4th St Rm 3a122b, Lubbock, TX 79430 | 2016-04-20 |
| 1619391760 | Chinyere Mbagwu | General Practice | 3601 4th St # Ms 8143, Lubbock, TX 79430 | 2014-02-10 |
| 1982044111 | Eileen Mary Sprys | Family Medicine | 3601 4th St., Stop 8143, Lubbock, TX 79430 | 2013-07-02 |
| 1205196243 | Hilmi Alam | Family Medicine | Department of Family & Community Medicine, 3601 4th Street, Stop 8143, Lubbock, TX 79430 | 2012-05-24 |
| Find all providers in zip 79430 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548616485 | Peter Clark | Ophthalmology | 3601 4th St Rm 2a100, Lubbock, TX 79430-1931 | 2016-05-10 |
| 1265810261 | William David Boothe Md Pa | Ophthalmology | 4020 21st St Ste 3, Lubbock, TX 79410-1126 | 2015-05-11 |
| 1104212661 | Coby Nielson Ray | Ophthalmology | 3601 4th St # Ms 7217, Lubbock, TX 79430-0002 | 2015-04-11 |
| 1194086561 | Donald Robert Lee May | Ophthalmology | 4611 9th St, Lubbock, TX 79416-4710 | 2012-06-01 |
| 1275796096 | Lingkun Kong | Ophthalmology | 3601 4th St Stop 7217, Lubbock, TX 79430-7217 | 2008-07-02 |
| 1558410266 | James J Boop, M.d.,p.a. | Ophthalmology | 2719 81st St, Lubbock, TX 79423-2229 | 2007-01-10 |
| 1336231265 | Charles E. Fisher Jr. | Ophthalmology | 4613 13th St, Lubbock, TX 79416-4823 | 2006-09-28 |
| 1295833614 | Frank M Ryburn IIi | Ophthalmology | 3420 23rd St, Lubbock, TX 79410-1322 | 2006-09-20 |
| 1205931136 | Billy Herbert Wilson | Ophthalmology | 4315 28th St, Suite 2, Lubbock, TX 79410 | 2006-09-14 |
| 1538262928 | John E Streit | Ophthalmology | 4014 22nd Pl, Ste 4, Lubbock, TX 79410 | 2006-09-07 |
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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.