| Regal Park Medical Center | |
|
8214 Milwaukee Ave Lubbock TX 79424-0923 | |
| (806) 795-6421 | |
| (806) 795-1528 |
| Full Name | Regal Park Medical Center |
|---|---|
| Speciality | Family Medicine |
| Location | 8214 Milwaukee Ave, Lubbock, Texas |
| Authorized Official Name and Position | Kirk J Tiemann (OWNER) |
| Authorized Official Contact | 8067956421 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Regal Park Medical Center 8214 Milwaukee Ave Lubbock TX 79424 Ph: (806) 795-6421 | Regal Park Medical Center 8214 Milwaukee Ave Lubbock TX 79424-0923 Ph: (806) 795-6421 |
| NPI Number | 1235495102 |
|---|---|
| Provider Enumeration Date | 04/05/2012 |
| Last Update Date | 02/25/2015 |
| Medicare PECOS PAC ID | 2466614292 |
|---|---|
| Medicare Enrollment ID | O20120424000363 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235495102 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | M9059 (Texas) | Primary |
| Provider Name | Kirk J Tiemann |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427249564 PECOS PAC ID: 5092888560 Enrollment ID: I20080716000379 |
| Provider Name | Madhu Polimeru |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1174954713 PECOS PAC ID: 1951619725 Enrollment ID: I20150928001252 |
| Provider Name | Byron Scharf |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1821681412 PECOS PAC ID: 0244630465 Enrollment ID: I20210609003234 |
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