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Organization

CONSULTANTS IN INFECTIOUS DISEASES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TONI ANN CLINE PA-C (ADMINISTRATOR)
(806) 795-8150
Entity
Organization

Contact information

Practice address
4404 19TH ST, STE. C, LUBBOCK, TX 79407-2424
(806) 795-8150
(806) 791-6688
Mailing address
PO BOX 16327, LUBBOCK, TX 79490-6327
(806) 795-8150
(806) 791-6688

Taxonomy

Speciality
Code
Description
License number
State
261QI0500X
Infusion Therapy Clinic/Center
Primary
15037
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0541920001
PALMETTO GBA
TX
01
082062301
FIRST CARE STAR
TX
01
082062301
FIRST CARE STAR
05
082062301
TX
01
103131100
FIRST CARE
TX
01
750678
BCBS HOME INFUSION THERAPY
TX
01
G9939
NEW MEXICO MEDICAID
Enumeration date
09/14/2009
Last updated
09/14/2009
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