Organization
TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER LUBBOCK
Active
Other names
TTUHSC/Anatomical Pathology
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRENT MAGERS (CEO)
(806) 743-1830
Entity
Organization
Contact information
Practice address
3601 4TH ST, STE 1A115, LUBBOCK, TX 79430-0002
(806) 743-2155
(806) 743-2117
Mailing address
PO BOX 27476, SALT LAKE CITY, UT 84127-0476
(806) 743-4263
(806) 743-2787
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
280869301
—
TX
05
—
280869303
—
TX
05
—
G1217
—
NM
Enumeration date
05/06/2006
Last updated
03/07/2022
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