1326166042 NPI number — MCCOMBS AND ASSOCIATES PHYSICAL THERAPY, INC.

Table of content: (NPI 1326166042)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326166042 NPI number — MCCOMBS AND ASSOCIATES PHYSICAL THERAPY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MCCOMBS AND ASSOCIATES PHYSICAL THERAPY, INC.
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:
1326166042
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/02/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9107 MILWAUKEE AVE
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:
79424
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
806-687-4311
Provider Business Mailing Address Fax Number:
806-687-4313

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9107 MILWAUKEE 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:
79424-2827
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-687-4311
Provider Business Practice Location Address Fax Number:
806-687-4313
Provider Enumeration Date:
03/27/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MCCOMBS
Authorized Official First Name:
SPENCER
Authorized Official Middle Name:
D
Authorized Official Title or Position:
PHYSICAL THERAPIST
Authorized Official Telephone Number:
806-317-9738

Provider Taxonomy Codes

  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1161388 . This is a "LICENSE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 660450000 . This is a "FACILITY REGISTRATION NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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