| Lubbock Integrated Medical Institute Pllc | |
|
2630 26th St Lubbock TX 79410-2220 | |
| (806) 765-8443 | |
| Not Available |
| Full Name | Lubbock Integrated Medical Institute Pllc |
|---|---|
| Speciality | General Practice |
| Location | 2630 26th St, Lubbock, Texas |
| Authorized Official Name and Position | Christopher Rose (OWNER) |
| Authorized Official Contact | 8067658443 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lubbock Integrated Medical Institute Pllc 2630 26th St Lubbock TX 79410-2220 Ph: (806) 765-8443 | Lubbock Integrated Medical Institute Pllc 2630 26th St Lubbock TX 79410-2220 Ph: (806) 765-8443 |
| NPI Number | 1790130169 |
|---|---|
| Provider Enumeration Date | 05/04/2016 |
| Last Update Date | 12/21/2021 |
| Medicare PECOS PAC ID | 9931591195 |
|---|---|
| Medicare Enrollment ID | O20220120000209 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790130169 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | K7879 (Texas) | Primary |
| Provider Name | Rita Esmeralda Corona |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336302173 PECOS PAC ID: 4981841509 Enrollment ID: I20130518000006 |
| Provider Name | Darla K Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043249188 PECOS PAC ID: 3678569993 Enrollment ID: I20150219000240 |
| Provider Name | Lauriana Nerios |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992359160 PECOS PAC ID: 7012248438 Enrollment ID: I20191015003153 |
| Provider Name | Misty Michelle Ruhland |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1619202967 PECOS PAC ID: 6204200835 Enrollment ID: I20230323000041 |
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