Organization
CEC DEZAVALA ER PHYSICIANS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN BRAXTON NEIMAN ESQ. (GENERAL COUNSEL)
(817) 421-0034
Entity
Organization
Contact information
Practice address
7007 INDIANA AVE, LUBBOCK, TX 79413-6113
(806) 701-4141
(817) 421-0036
Mailing address
PO BOX 92695, SOUTHLAKE, TX 76092-0695
(817) 421-0034
(817) 421-0036
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
—
—
Other
Enumeration date
03/30/2015
Last updated
03/04/2025
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