TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER LUBBOCK (NPI# 1972552263) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972552263 |
| Entity Type | Organization |
| Organization Name | TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER LUBBOCK |
| Practice Address |
3601 4th St Lubbock TX 79430 |
| Mailing Address |
Po Box 27476 Salt Lake City UT 84127-0476 |
| Practice Telephone | 8067437337 |
| Practice Fax Number | 8067432314 |
| 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 ADMINISTR) |
| 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 | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BC/BS | 00QQ71 | 01 |
| NM | G1217 | 05 | |
| TX | RAILROAD MEDICARE | CD9207 | 01 |
| TX | 084585101 | 05 | |
| TX | 140327131 | 05 | |
| TX | 084585102 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1400 S Coulter St # 1400, Amarillo, TX 791061786 | 8064109800 | 8063545689 |
| 3001 Jbs Pkwy, Odessa, TX 797628126 | 8067437700 | 8067437703 |
| 400 Rosalind Redfern Grover Pkwy Ste 251, Midland, TX 797015857 | 8067437700 | 8067437703 |
| 4015 22nd Pl, Lubbock, TX 794101119 | 8067256000 | 8067237753 |
| 4101 22nd Pl, Lubbock, TX 794101121 | 8067258000 | 8067254847 |
| 4102 24th St, Lubbock, TX 794101806 | 8067437700 | 8067437703 |
| 4102 24th St Ste 205, Lubbock, TX 794101801 | 8067254840 | 8067254847 |
| 4302 Princeton St, Lubbock, TX 794151304 | 8067492222 | 8067408570 |
| 6610 Quaker Ave, Lubbock, TX 794135938 | 8067434270 | 8067439097 |
| 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 |
| City | LUBBOCK |
| State | TX |
| Zip Code | 79430 |
| 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 |
| Find all providers in the same location | ||||
| 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 | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689188484 | Sarada Devi Narendran | Pediatrics | 9313 Salisbury Ave, Lubbock, TX 79424-5023 | 2017-12-01 |
| 1104237015 | Coby Robins | Pediatrics | Ttuhsc, Department of Pediatrics, Lubbock, TX 79430-0002 | 2014-05-13 |
| 1801227483 | Glenn Joseph Boris | Pediatrics | 3204 44th St, Lubbock, TX 79413-3506 | 2013-12-06 |
| 1508122110 | Mirla L Avila | Pediatrics | 3601 4th Street, Ms 8321, Dept. of Neurology, Lubbock, TX 79430 | 2012-04-09 |
| 1437435856 | West Texas Kid's Clinic, Pllc | Pediatrics | 5004 Frankford Ave Unit 400, Lubbock, TX 79424-1138 | 2011-10-31 |
| 1477864130 | Rebekah Grace Phillips | Pediatrics | 3601 4th St Stop 9406, Department of Pediatrics Ttuhsc, Lubbock, TX 79430-0002 | 2010-06-28 |
| 1013243278 | Jane Elizabeth Wheeler | Pediatrics | 4617 92nd St, Lubbock, TX 79424-5033 | 2009-10-22 |
| 1861636862 | Celeste Xochitl Twelves Caballero | Pediatrics | 5202 82nd St, Lubbock, TX 79424-2823 | 2009-04-22 |
| 1578713244 | Jeremy Robert Dalton | Pediatrics | 4102 24th St Ste 103, Lubbock, TX 79410-1800 | 2008-09-30 |
| 1306016019 | Maurice Asmussen | Pediatrics | 1313 Broadway Ste 5, Lubbock, TX 79401-3209 | 2008-03-10 |
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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.