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Organization
LACY MEDICAL GROUP INC
Active
Organization
LACY MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FREDERICK R ONGER (CEO)
(806) 281-2178
Entity
Organization
Contact information
Practice address
405 SLIDE RD, STE 111-115, LUBBOCK, TX 79416-4356
(806) 281-2178
Mailing address
405 SLIDE RD, STE 111-115, LUBBOCK, TX 79416-4356
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
K4760
TX
Other
Enumeration date
12/29/2008
Last updated
12/29/2008
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