Individual
DEREK IAN SKINNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7601 QUAKER AVE, LUBBOCK, TX 79424-3360
(806) 725-9603
(806) 725-9600
Mailing address
3420 22ND PLACE, LUBBOCK, TX 79410
(806) 725-7800
(806) 723-6532
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
L8194
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
138415101
FIRSTCARE
TX
05
—
164626703
—
TX
01
—
8A8646
BCBS
TX
Enumeration date
04/11/2006
Last updated
05/04/2015
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