Individual
SUZANNE SELF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
10507 QUAKER AVE, SUITE A, LUBBOCK, TX 79424-8442
(806) 701-5425
Mailing address
4802 N LOOP 289, PREMIERE CLINIC, LUBBOCK, TX 79416-3025
(806) 788-0040
(806) 788-0015
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA02423
TX
Other
Enumeration date
03/08/2006
Last updated
09/17/2016
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