Individual
VICTOR MANUEL REVELES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
602 INDIANA AVE, LUBBOCK, TX 79415-3364
(806) 775-8715
Mailing address
5236 ITASCA ST, LUBBOCK, TX 79416-1229
(806) 544-9033
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
GMR02000454
TX
Other
Enumeration date
06/14/2024
Last updated
06/14/2024
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