Organization
RUSHLAND PARK SURGICENTER, LP
Active
Other names
Lubbock Plastic Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. C MICHEL OLIVA MD (OWNER/MEDICAL DIRECTOR)
(806) 791-3377
Entity
Organization
Contact information
Practice address
4404 6TH ST, LUBBOCK, TX 79416-4732
(806) 791-3377
(806) 791-3378
Mailing address
4404 6TH ST, LUBBOCK, TX 79416-4732
(806) 791-3377
(806) 791-3378
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000HH1371
BLUE CRSS & BLUE SHIELD
TX
01
—
1023122876
NPI
—
Enumeration date
08/18/2006
Last updated
09/02/2025
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