TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER LUBBOCK (NPI# 1548219827) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548219827 |
| Entity Type | Organization |
| Organization Name | TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER LUBBOCK |
| Other Organization Name | TTUHSC- DERMATOLOGY |
| Practice Address |
3601 4th St Ste 4a100 Lubbock TX 79430-0002 |
| Mailing Address |
Po Box 27476 Salt Lake City UT 84127-0476 |
| Practice Telephone | 8067431842 |
| Practice Fax Number | 8067431105 |
| 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 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 | ||
| N | 207ND0900X |
Dermatology Specialization: Dermatopathology |
Allopathic & Osteopathic Physicians | ||
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100708740A | 05 | |
| TX | BC/BS | 00QQ84 | 01 |
| TX | 084590101 | 05 | |
| TX | 140327105 | 05 | |
| TX | RAILROAD MEDICARE | CD9207 | 01 |
| NM | G1217 | 05 |
| Other Name | Type Code |
|---|---|
| TTUHSC- Dermatology | Doing Business As Name - 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 |
| 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 |
| 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 |
3601 4TH ST STE 4A100 |
| 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 | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962928440 | Long & Harris Dermatology Pllc | Dermatology | 6102 82nd St Ste 15, Lubbock, TX 79424-0802 | 2017-08-16 |
| 1649711904 | William David Boothe Jr. | Dermatology | 3601 4th St Stop 6211, Lubbock, TX 79430 | 2017-03-19 |
| 1033572136 | Uyen Ngoc Mui | Dermatology | 3601 4th St Stop 9400, Lubbock, TX 79430-9400 | 2016-04-05 |
| 1548363971 | Robert Franklin Bloom | Dermatology | 3413 20th St, Lubbock, TX 79410 | 2006-09-07 |
| 1285642603 | Michael Hood Chamales | Dermatology | 15010 Slide Dr, Lubbock, TX 79424 | 2006-08-03 |
| 1427087345 | Lehman Dermatology Clinic, P.a. | Dermatology | 3715 21st St, Lubbock, TX 79410-1219 | 2006-07-02 |
| 1093701468 | Brent R. Paulger | Dermatology | 2202 Ithaca Ave, Lubbock, TX 79410-1332 | 2005-09-21 |
| 1639164098 | Justin Wayne Clark | Dermatology | 3601 22nd St, Lubbock Dermatology, Lubbock, TX 79410-1309 | 2005-09-13 |
| 1922463959 | Skin Cancer Institute Pllc | Dermatology | 4709 66th St, Lubbock, TX 79414-4877 | 2015-12-17 |
| 1629488143 | Randy Atkins | Dermatology | 3601 4th St, Ms 9410, Lubbock, TX 79430-0002 | 2014-05-06 |
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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.