Organization
TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER LUBBOCK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENT MAGERS (ASSISTANT DEAN OF FINANCE ADMIN)
(806) 743-1830
Entity
Organization
Contact information
Practice address
3601 4TH ST, LUBBOCK, TX 79430
(806) 743-2373
(806) 743-2113
Mailing address
PO BOX 27476, SALT LAKE CITY, UT 84127-0476
(806) 743-2898
(806) 743-2787
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00QQ72
BC/BS
TX
05
—
084586901
—
TX
05
—
140327122
—
TX
01
—
CD9207
RAILROAD MEDICARE
TX
05
—
G1217
—
NM
Enumeration date
05/06/2006
Last updated
03/08/2022
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