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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