1376549113 NPI number — DAVID FINCHER CRNA

Table of content: DAVID FINCHER CRNA (NPI 1376549113)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376549113 NPI number — DAVID FINCHER CRNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FINCHER
Provider First Name:
DAVID
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CRNA
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1376549113
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/10/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 5865
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:
79408-5865
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
806-743-2898
Provider Business Mailing Address Fax Number:
806-743-2787

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3601 4TH ST
Provider Second Line Business Practice Location Address:
SUITE 1C282
Provider Business Practice Location Address City Name:
LUBBOCK
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79430-8182
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-743-2981
Provider Business Practice Location Address Fax Number:
806-743-2984
Provider Enumeration Date:
06/27/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 367500000X , with the licence number:  612720 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 68869 . This is a "PRESBYTERIAN COMMERCIAL" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: 112688100 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 68869 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
  • Identifier: A524 . This is a "TRIWEST" identifier . This identifiers is of the category "OTHER".
  • Identifier: 21434506 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
  • Identifier: 112688101 . This is a "FIRSTCARE COMMERCIAL" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 154261501 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100785540A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".




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