Individual
DR. KENN ALAN FREEDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3601 4TH ST, 2A100, LUBBOCK, TX 79430-0002
(806) 743-2020
(806) 743-1782
Mailing address
PO BOX 5865, LUBBOCK, TX 79408-5865
(806) 743-2898
(806) 743-2787
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
H8052
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100211700A
—
OK
05
—
100890601
—
TX
05
—
100890602
—
TX
01
—
113026100
FIRSTCARE COMMERCIAL
TX
05
—
113026102
—
TX
01
—
64022
PRESBYTERIAN COMMERCIAL
TX
05
—
64022
—
NM
01
—
84332Z
HMO BLUE
TX
01
—
86941X
BC/BS
TX
05
—
B3415
—
NM
01
—
E002
TRIWEST
NM
Enumeration date
10/31/2005
Last updated
01/15/2014
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