1992708705 NPI number — LUBBOCK REGIONAL MHMR CENTER

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992708705 NPI number — LUBBOCK REGIONAL MHMR CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LUBBOCK REGIONAL MHMR CENTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1992708705
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/03/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2828
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LUBBOCK
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79408-2828
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
806-766-0310
Provider Business Mailing Address Fax Number:
806-766-0250

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1950 ASPEN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LUBBOCK
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79404-1211
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-766-0213
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/24/2005

Additional Information

Authorized Official

Authorized Official Last Name:
LAWSON
Authorized Official First Name:
BETH
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
806-767-1648

Provider Taxonomy Codes

  • Taxonomy code: 171M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251T00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM0801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM0850X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM0855X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM2800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QP2300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QR0405X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 283Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 315P00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 320900000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0848970-01 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 001018313 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1364929-03 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1364929-09 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1364929-01 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1364929-11 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1D9349 . This is a "MEDICARE B OTP" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1364929-07 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1364929-08 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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