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Individual

KENNETH MICHAEL NUGENT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3601 4TH ST, LUBBOCK, TX 79430-9410
(806) 743-3150
(806) 743-3168
Mailing address
PO BOX 5865, LUBBOCK, TX 79408-5865
(806) 743-3150
(806) 743-3168

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
G7699
TX
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
G7699
TX
207RP1001X
Pulmonary Disease Physician
Primary
G7699
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100158220A
OK
01
120541100
FIRSTCARE COMMERCIAL
TX
05
120541101
TX
05
136092701
TX
05
136092706
TX
01
43974
PRESBYTERIAN COMMERCIAL
NM
05
43974
NM
01
80767Z
HMO BLUE
TX
01
85E051
BC/BS
TX
01
A035
TRIWEST
NM
01
M0057696
DPS
TX
05
U4765
NM
Enumeration date
10/20/2005
Last updated
12/02/2021
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