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Organization

DEPARTMENT OF STATE HEALTH SERVICES

Active
Other names
Texas DSHS - HSR 1 Lubbock
Organization subpart
No

Provider details

NPI number
Authorized official
BARRY WILSON (DEPUTY REGIONAL DIRECTOR)
(806) 744-3577
Entity
Organization

Contact information

Practice address
6302 LOLA, LUBBOCK, TX 79424
(806) 744-3577
(806) 783-6475
Mailing address
1100 W. 49TH ST., AUSTIN, TX 78756
(806) 458-7111

Taxonomy

Speciality
Code
Description
License number
State
261QP0905X
State or Local Public Health Clinic/Center
Primary
H4610
TX
261QP0905X
State or Local Public Health Clinic/Center
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
133560602
TX
05
135248602
TX
05
136129702
TX
05
136130504
TX
05
136368102
TX
05
136480402
TX
05
138359805
TX
05
138359808
TX
Enumeration date
11/28/2006
Last updated
08/31/2010
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