Organization
SOUTH PLAINS RURAL HEALTH SERVICES, INC.
Active
Other names
South Plains Dental Lamesa
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUDITH MADURA M.D. (CHIEF EXECUTIVE DIRECTOR)
(806) 894-7842
Entity
Organization
Contact information
Practice address
1005 NORTH 16TH STREET, LAMESA, TX 79331-3151
(806) 872-6310
(806) 872-6319
Mailing address
1000 FM 300, LEVELLAND, TX 79336-6235
(806) 897-1987
(806) 894-3378
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019049801
—
TX
05
—
180034401
—
TX
05
—
386569302
—
TX
Enumeration date
08/16/2006
Last updated
08/10/2022
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