Individual
OBIE LEE STALCUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4515 MARSHA SHARP FWY, LUBBOCK, TX 79407-2520
(806) 744-7223
(806) 740-3325
Mailing address
2804 N LOOP 289, LUBBOCK, TX 79415-1410
(806) 744-7223
(806) 740-3325
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
D1064
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
099733004
—
TX
01
—
124642101
FIRSTCARE
TX
01
—
5943079
AETNA
TX
01
—
8V8699
BCBS
TX
01
—
P00333606
MEDICARE RAILROAD
—
Enumeration date
05/04/2006
Last updated
12/01/2021
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