# UMC PHYSICIAN NETWORK SERVICES

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

## Provider details

- **NPI number:** 1952580433
- **Authorized official:** MRS. JENNETT AZZINARO (MANAGER, CENTRAL BUSINESS OPERATION)
- **Authorized official phone:** (806) 761-0334

## Contact information

- **Practice address:** 4004 82ND ST, LUBBOCK, TX 79423-1900
- **Practice address phone:** (806) 722-3150
- **Practice address fax:** (806) 722-4674
- **Mailing address:** 5219 CITY BANK PKWY, STE 35, LUBBOCK, TX 79407-3544
- **Mailing address phone:** (806) 761-0334
- **Mailing address fax:** (806) 722-2908

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0200X | Radiology Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 10/31/2007
- **Last updated:** 01/03/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 147762201 | — | TX |
| 01 | — | FTX078 | BLUE CROSS BLUE SHIELD | TX |