1992896633 NPI number — RADIATION ONCOLOGY OF THE SOUTH PLAINS, P.A.

Table of content: (NPI 1992896633)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992896633 NPI number — RADIATION ONCOLOGY OF THE SOUTH PLAINS, P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RADIATION ONCOLOGY OF THE SOUTH PLAINS, P.A.
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:
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:
1992896633
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/01/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2202 MEMPHIS AVE
Provider Second Line Business Mailing Address:
202
Provider Business Mailing Address City Name:
LUBBOCK
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79410-1342
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
806-793-1406
Provider Business Mailing Address Fax Number:
806-796-1167

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4002 21ST ST
Provider Second Line Business Practice Location Address:
STE A
Provider Business Practice Location Address City Name:
LUBBOCK
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79410-1135
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-793-1406
Provider Business Practice Location Address Fax Number:
806-796-1167
Provider Enumeration Date:
09/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CHOU
Authorized Official First Name:
JUI-LIEN
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
806-793-1406

Provider Taxonomy Codes

  • Taxonomy code: 207RH0003X , with the licence number:  M8619 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0001X , with the licence number: H0985 , 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)





Copyright © 2007-2025 www.npivalidator.com