1538130737 NPI number — LUBBOCK TEXAS HIGHLAND MEDICAL CENTER, L.P.

Table of content: (NPI 1538130737)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538130737 NPI number — LUBBOCK TEXAS HIGHLAND MEDICAL CENTER, L.P.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LUBBOCK TEXAS HIGHLAND MEDICAL CENTER, L.P.
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:
1538130737
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/14/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2412 50TH STREET
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:
79412
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
806-788-4060
Provider Business Mailing Address Fax Number:
806-788-4278

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2412 50TH ST
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:
79412-2504
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-788-4100
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MEEKS
Authorized Official First Name:
RODNEY
Authorized Official Middle Name:
L
Authorized Official Title or Position:
V.P. OPERATIONS
Authorized Official Telephone Number:
806-788-4060

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  000013 , 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: 050209 . This is a "AETNA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 628232264 . This is a "MEDICAID NM" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: 135238706 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: HH0114 . This is a "BLUE CROSS PROVIDER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 7523902391 . This is a "PCCA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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