Organization
TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER LUBBOCK
Active
Other names
TTUHSC- OB/GYN
Organization subpart
No
Provider details
NPI number
Authorized official
BRENT MAGERS (ASSISTANT DEAN OF FINANCE ADMINISTR)
(806) 743-1830
Entity
Organization
Contact information
Practice address
3601 4TH ST, LUBBOCK, TX 79430
(806) 743-2340
(806) 743-1775
Mailing address
PO BOX 27476, SALT LAKE CITY, UT 84127-0476
(806) 743-2898
(806) 743-2787
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00QQ85
BC/BS
TX
05
—
095229303
—
TX
05
—
140327124
—
TX
01
—
CD9207
RAILROAD MEDICARE
TX
05
—
G1217
—
NM
Enumeration date
05/06/2006
Last updated
03/07/2022
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