# GIRISH C. VALLABHAN MD PA

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

## Provider details

- **NPI number:** 1255519716
- **Authorized official:** MR. BRYAN L WILLIAMS BBA CPC (CREDENTIALING MANAGER)
- **Authorized official phone:** (806) 771-1166

## Contact information

- **Practice address:** 3821 22ND ST, SUITE B, LUBBOCK, TX 79410-1113
- **Practice address phone:** (806) 790-5897
- **Mailing address:** 3821 22ND ST, SUITE B, LUBBOCK, TX 79410-1113
- **Mailing address phone:** (806) 790-5897

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | 92-154 | TX | Yes |

## Other

- **Enumeration date:** 02/07/2008
- **Last updated:** 02/07/2008