Individual
GREGORY ALFRED NESTEBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LO BOC ABC ORTHODONT
Contact information
Practice address
2535 34TH STREET, LUBBOCK, TX 79410
(806) 792-6193
(806) 792-2863
Mailing address
2535 34TH STREET, LUBBOCK, TX 79410
(806) 792-6193
(806) 792-2863
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
377
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
513122
BCBS
NM
01
—
513122
BCBS
TX
Enumeration date
10/25/2006
Last updated
07/08/2007
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