Individual
TORI GUSTAFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
3601 4TH ST, SUITE 2A300, LUBBOCK, TX 79430-0002
(806) 743-5678
(806) 743-5670
Mailing address
PO BOX 5865, LUBBOCK, TX 79408-5865
(806) 743-2898
(806) 743-2787
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
50936
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022426301
—
TX
05
—
022426302
—
TX
05
—
100671140A
—
OK
01
—
201021516
PRESBYTERIAN COMMERCIAL
NM
05
—
201021516
—
NM
01
—
80138A
BC/BS
TX
01
—
80761Z
HMO BLUE
TX
01
—
A269
TRIWEST
NM
05
—
Q6377
—
NM
Enumeration date
01/02/2006
Last updated
11/19/2021
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