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Organization
LUBBOCK PLASTIC SURGERY CENTER, LP
Active
Organization
LUBBOCK PLASTIC SURGERY CENTER, LP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHAD RICKY SOUTHARD FACHE, FHFMA (ADMINISTRATOR)
(806) 797-6398
Entity
Organization
Contact information
Practice address
10105 QUAKER AVE, LUBBOCK, TX 79424-7380
(806) 797-6398
(806) 797-6399
Mailing address
10105 QUAKER AVE, LUBBOCK, TX 79424-7380
(806) 797-6398
(806) 797-6399
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
05/26/2016
Last updated
05/26/2016
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