Provider First Line Business Practice Location Address:
DEPARTMENT OF DERMATOLOGY 3601 4TH STREET - STOP 9400
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:
79430-3411
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-743-5630
Provider Business Practice Location Address Fax Number:
806-743-1603
Provider Enumeration Date:
04/05/2019