Organization
COVENANT MEDICAL GROUP
Active
Organization
COVENANT MEDICAL GROUP
Active
Other names
Covenant Family Healthcare Center
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTEN KOTHMANN (COO/VP)
(806) 725-7800
Entity
Organization
Contact information
Practice address
409 8TH ST, ABERNATHY, TX 79311-3416
(806) 298-5884
(806) 298-5889
Mailing address
2215 NASHVILLE AVE, LUBBOCK, TX 79410-1105
(806) 725-5844
(806) 723-6532
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
328182601
—
TX
01
—
673910
MEDICARE
TX
Enumeration date
10/23/2012
Last updated
09/23/2020
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