Organization
TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER LUBBOCK
Active
Other names
TTUHSC- Dermatology
Organization subpart
No
Provider details
NPI number
Authorized official
BRENT MAJORS (ASSISTANT DEAN FINANCE ADMIN)
(806) 743-1830
Entity
Organization
Contact information
Practice address
3601 4TH ST, STE 4A100, LUBBOCK, TX 79430-0002
(806) 743-1842
(806) 743-1105
Mailing address
PO BOX 27476, SALT LAKE CITY, UT 84127-0476
(806) 743-4263
(806) 743-2787
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0900X
Dermatopathology Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00QQ84
BC/BS
TX
05
—
084590101
—
TX
05
—
100708740A
—
OK
05
—
140327105
—
TX
01
—
CD9207
RAILROAD MEDICARE
TX
05
—
G1217
—
NM
Enumeration date
05/06/2006
Last updated
01/11/2022
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