Individual
DR. JOHNNY A QUBTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MEDICAL DOCTOR
Contact information
Practice address
3601 21ST ST, SUITE 3-A, LUBBOCK, TX 79410-1229
(806) 771-7877
(806) 771-7474
Mailing address
3601 21ST ST, SUITE 3-A, LUBBOCK, TX 79410-1229
(806) 771-7877
(806) 771-7474
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
H2703
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0070LP
BLUE CROSS BLUE SHIELD
TX
01
—
050018039
RAILROAD MEDICARE
TX
05
—
130361208
—
TX
Enumeration date
02/01/2006
Last updated
11/15/2007
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