Individual
KALARICKAL J OOMMEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3506 21ST ST, SUITE 400, LUBBOCK, TX 79410
(806) 725-4115
(806) 723-7007
Mailing address
2215 NASHVILLE AVE, LUBBOCK, TX 79410-1105
(806) 725-5844
(806) 723-6532
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
11431
OK
2084N0400X
Neurology Physician
N4871
TX
2084N0600X
Clinical Neurophysiology Physician
Primary
N4871
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
195950403
—
TX
01
—
8BS951
BCBS TX
TX
05
—
W5011
—
NM
Enumeration date
03/08/2006
Last updated
07/16/2018
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