| |
6501 University Ave Ste 600 Lubbock TX 79413-5849 | |
(806) 743-2424 | |
(806) 743-9633 |
Full Name | |
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Speciality | Clinic/Center |
Location | 6501 University Ave Ste 600, Lubbock, Texas |
Authorized Official Name and Position | Linda Mcmurry (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 8067439355 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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301 40th St Lubbock TX 79404-2746 Ph: (806) 743-9355 | 6501 University Ave Ste 600 Lubbock TX 79413-5849 Ph: (806) 743-2424 |
NPI Number | 1750702015 |
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Provider Enumeration Date | 01/03/2014 |
Last Update Date | 11/26/2024 |
Medicare PECOS PAC ID | 9537158886 |
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Medicare Enrollment ID | O20140411000262 |
Identifier | Type | State | Issuer |
---|---|---|---|
1750702015 | NPI | - | NPPES |
333188601 | Medicaid | TX | |
333188602 | Medicaid | TX | |
741841 | Other | TX | MEDICARE PIN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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