MR. ROBERT NEAL PORTWOOD (NPI# 1740519628) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740519628 |
| Entity Type | Individual |
| Full Name | MR. ROBERT NEAL PORTWOOD |
| Credential | PA-C |
| Practice Address |
602 Indiana Ave Lubbock TX 79415-3364 |
| Mailing Address |
5306 County Road 7360 Lubbock TX 79424-7316 |
| Practice Telephone | 8067759700 |
| Enumeration Date | 2009-12-23 |
| Last Update Date | 2017-07-25 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA06544 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
602 INDIANA AVE |
| City | LUBBOCK |
| State | TX |
| Zip Code | 79415-3364 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487659876 | Mark Brendan Reedy | Obstetrics & Gynecology | 602 Indiana Ave, Lubbock, TX 79415-3364 | 2005-06-14 |
| 1417571613 | Chelsea Brooke Seaton | Student in an Organized Health Care Education/Training Program | 602 Indiana Ave, Lubbock, TX 79415-3364 | 2020-06-03 |
| 1437773728 | John Clinton Fisher IIi | Student in an Organized Health Care Education/Training Program | 602 Indiana Ave, Lubbock, TX 79415-3364 | 2020-06-02 |
| 1700409448 | Ryan Everett Hirata | Student in an Organized Health Care Education/Training Program | 602 Indiana Ave, Lubbock, TX 79415-3364 | 2020-05-28 |
| 1013530716 | Lillian Amezquita | Student in an Organized Health Care Education/Training Program | 602 Indiana Ave, Lubbock, TX 79415-3364 | 2020-05-28 |
| 1457990186 | Madison Dreu Williams | Registered Nurse | 602 Indiana Ave, Lubbock, TX 79415-3364 | 2019-12-28 |
| 1972145977 | Alicia Garcia Castanon | Nurse Practitioner | 602 Indiana Ave, Lubbock, TX 79415-3364 | 2019-10-10 |
| 1770133746 | Candace Kernell | Registered Nurse | 602 Indiana Ave, Lubbock, TX 79415-3364 | 2019-09-12 |
| 1154883767 | James William Woodwick Jr. | Nurse Practitioner | 602 Indiana Ave, Lubbock, TX 79415-3364 | 2019-04-02 |
| 1811455066 | Rolando Adolfo Lugo II | Nurse Practitioner | 602 Indiana Ave, Lubbock, TX 79415-3364 | 2019-03-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831569540 | Community Health Center of Lubbock, Inc. | Clinic/Center | 3502 9th St Ste 280, Lubbock, TX 79415 | 2015-10-07 |
| 1922447457 | Fnu Parijat Kumar | Physical Therapist | 2717 3rd Street, Aptt 803, Lubbock, TX 79415 | 2013-06-18 |
| 1851575906 | Diego Rivera, M.d., P.a. | Family Medicine | 111 University Ave, Lubbock, TX 79415 | 2007-12-26 |
| 1730206632 | Kathleen Brinkman Felts | Physical Therapist | 3710 4th Street, Lubbock, TX 79415 | 2007-03-23 |
| 1568508521 | Horace Rueben Sharp Jr. | Optometrist | 1911 4th St, Lubbock, TX 79415 | 2007-01-29 |
| 1699876201 | Patricia R. Arledge | Plastic Surgery | 3502 9th St., Suite 270, Lubbock, TX 79415 | 2006-09-26 |
| 1245330018 | Perlita Molina Sambrano-tandoc | Nurse Practitioner | 602 East Indiana Avenue, Lubbock, TX 79415 | 2006-09-22 |
| 1639199862 | Justin Tidwell | Emergency Medicine | 604 Indiana, Lubbock, TX 79415 | 2006-07-20 |
| 1912944059 | Community Health Center of Lubbock, Inc. | Clinic/Center | 3301 Clovis Road, Lubbock, TX 79415 | 2006-05-31 |
| 1497709265 | Byron Wayne Schoettle | Radiology | 602 Indiana Avenue, Lubbock, TX 79415 | 2006-05-19 |
| Find all providers in zip 79415 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316294408 | Ronald Caporale | Physician Assistant | 1701 50th Street, Lubbock, TX 79412 | 2012-08-08 |
| 1699002675 | Jamie Fletcher | Physician Assistant | 5415 114th St, Lubbock, TX 79424 | 2009-11-11 |
| 1710160700 | Jessica Ferguson | Physician Assistant | 3606 21st St Ste 200, Lubbock, TX 79410-1225 | 2007-12-12 |
| 1104958560 | Janice Hallford Lampe | Physician Assistant | 6048 Marsha Sharp Fwy, Lubbock, TX 79407-3726 | 2007-03-12 |
| 1699819953 | Holly Jen Tyson | Physician Assistant | 3811 24th St, Lubbock, TX 79410-1813 | 2007-02-19 |
| 1154496974 | Kathleen Jo Marcum | Physician Assistant | 3801 21st St, Suite 200, Lubbock, TX 79410-1006 | 2006-11-21 |
| 1336252220 | Gustavo Alonso Bendeck | Physician Assistant | 4010 22nd St, Lubbock, TX 79410-1116 | 2006-08-16 |
| 1316903875 | Kristina Lee | Physician Assistant | 3904 101st St, Lubbock, TX 79423-5725 | 2006-04-25 |
| 1467416636 | David Anthony King | Physician Assistant | 3514 21st Street, Lubbock, TX 79410 | 2006-04-14 |
| 1346246634 | Phyllis Rose Peterson | Physician Assistant | Ttuhsc Dept of Psychiatry, 3601 4th St., Ms 8103, Lubbock, TX 79430-8103 | 2005-06-22 |
| Find all providers in LUBBOCK | ||||
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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.