Individual
TIMOTHY LEWIS BOOMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4417 71ST ST, SUITE 42, LUBBOCK, TX 79424-2394
(806) 799-2991
(806) 793-5331
Mailing address
4417 71ST ST, SUITE 42, LUBBOCK, TX 79424-2394
(806) 799-2991
(806) 793-5331
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
363AS0400X
Surgical Physician Assistant
—
TX
Other
Enumeration date
10/23/2012
Last updated
02/16/2024
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