TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER LUBBOCK (NPI# 1518916808) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518916808 |
| Entity Type | Organization |
| Organization Name | TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER LUBBOCK |
| Other Organization Name | TTUHSC/ NEUROLOGY |
| Practice Address |
3601 4th St Room 3a105 Lubbock TX 79430-0002 |
| Mailing Address |
Po Box 27476 Salt Lake City UT 84127-0476 |
| Practice Telephone | 8067432391 |
| Practice Fax Number | 8067435687 |
| Mailing Telephone | 8067434263 |
| Mailing Fax Number | 8067432787 |
| Enumeration Date | 2006-05-06 |
| Last Update Date | 2019-10-01 |
| Authorized Official Name | BRENT MAJORS (ASSISTANT DEAN OF FINANCE ADMIN) |
| Authorized Official Telephone | 8067431830 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities | ||
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 084593504 | 05 | |
| TX | 084593503 | 05 | |
| NM | G1217 | 05 | |
| TX | RAILROAD MEDICARE | CD9207 | 01 |
| TX | BC/BS | 00QQ88 | 01 |
| Other Name | Type Code |
|---|---|
| TTUHSC/ Neurology | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1008 Canton Ave Bldg 151, Lubbock, TX 794099838 | 8067423400 | 8067423400 |
| 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 |
| 1164979142 | Texas Tech University Health Sciences Center Lubbock | Psychiatry & Neurology | 1008 Canton Ave, Room 018bf, Lubbock, TX 79409-3132 | 2016-09-07 |
| 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 |
| Street Address |
3601 4TH ST ROOM 3A105 |
| 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 | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619383056 | Doungporn Ruthirago | Psychiatry & Neurology | 3601 4th St Stop 8321, Department of Neurology, Lubbock, TX 79430-8321 | 2014-07-07 |
| 1528259900 | Benjamin J. Williams Md, Phd, Pa | Psychiatry & Neurology | 4642 N Loop 289 Ste 203, Lubbock, TX 79416-2424 | 2007-08-09 |
| 1033281373 | Annie Lincoln | Psychiatry & Neurology | 2310 Indiana Ave, Lubbock, TX 79410-2142 | 2006-11-14 |
| 1649363326 | Health and Human Services Commission | Psychiatry & Neurology | 3401 N University Ave, Lubbock, TX 79415-1734 | 2006-10-02 |
| 1306822242 | Jongyeol Kim | Psychiatry & Neurology | 3601 4th St # Ms 8321, Lubbock, TX 79430-0002 | 2005-12-22 |
| 1609369990 | Jie Pan | Psychiatry & Neurology | 3601 4th St Stop 8321, Lubbock, TX 79430-8321 | 2018-06-11 |
| 1619497161 | Smathorn Thakolwiboon | Psychiatry & Neurology | 3601 4th St Stop 8321, Lubbock, TX 79430-8321 | 2017-06-26 |
| 1053831693 | Dargelis Chi | Psychiatry & Neurology | 3601 4th St Stop 8321, Lubbock, TX 79430-8321 | 2017-06-25 |
| 1508310111 | Dongkwan Jin | Psychiatry & Neurology | 3601 4th St, Ttuhsc, Department of Neurology, Lubbock, TX 79430-8321 | 2016-08-11 |
| 1770036881 | Juliana Bertha D Gomez Abanto | Psychiatry & Neurology | 3601 4th St Stop 8321, Lubbock, TX 79430-8321 | 2016-07-26 |
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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.