Individual
LARRY DALE WHITCOMB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3601 4TH ST, LUBBOCK, TX 79430-8312
(806) 778-4457
Mailing address
PO BOX 540040, GRAND PRAIRIE, TX 75054-0040
(972) 988-1006
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
F5798
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
089609401
—
TX
Enumeration date
07/11/2006
Last updated
03/07/2013
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