# EPIPHANY MEDICAL SERVICES PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033963731
- **Authorized official:** JEFFREY HANNEL MD (PRESIDENT)
- **Authorized official phone:** (806) 576-3856

## Contact information

- **Practice address:** 13810 QUAKER AVE, LUBBOCK, TX 79424
- **Practice address phone:** (806) 576-3856
- **Practice address fax:** (806) 305-3348
- **Mailing address:** PO BOX 65074, LUBBOCK, TX 79464-5074

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/17/2024
- **Last updated:** 04/17/2024