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Individual

JAKE WILLIAM WESTERBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
9812 SLIDE RD, LUBBOCK, TX 79424-5781
(806) 725-8690
(806) 725-8691
Mailing address
3420 22ND PL, LUBBOCK, TX 79410-1314
(806) 725-5844
(806) 723-6532

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
Q1769
TX
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
06/06/2012
Last updated
08/06/2015
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