Individual
DR. JUSTIN ERIC ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4315 28TH ST, LUBBOCK, TX 79410-2507
(806) 792-2104
Mailing address
4315 28TH ST, LUBBOCK, TX 79410-2507
(806) 792-2104
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
237829-1
NY
207W00000X
Ophthalmology Physician
Primary
M9125
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8H3782
BLUE CROSS BLUE SHIELD
TX
Enumeration date
01/11/2007
Last updated
10/01/2008
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