Organization
LUBBOCK KIDNEY & BLOOD PRESSURE CLINIC P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLARENCE J WHEELER III M.D. (M.D. PRESIDENT)
(806) 793-8447
Entity
Organization
Contact information
Practice address
1126 SLIDE RD, SUITE 4B, LUBBOCK, TX 79416-5402
(806) 793-8447
(806) 793-0498
Mailing address
1126 SLIDE RD, SUITE 4B, LUBBOCK, TX 79416-5402
(806) 793-8447
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00DG98
BLUECROSS BLUESHIELD
TX
05
—
082186001
—
TX
01
—
C12381
PALAMETTO RAILROAD MEDICA
TX
05
—
G-8915
—
NM
Enumeration date
08/11/2006
Last updated
05/16/2013
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