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Individual

ITIKANA DEB ROY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
9812 SLIDE RD, LUBBOCK, TX 79424-5781
(806) 725-8447
(806) 725-8448
Mailing address
2215 NASHVILLE AVE, LUBBOCK, TX 79410-1105
(806) 725-5844
(806) 723-6532

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
L2613
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
150433401
TX
Enumeration date
05/23/2006
Last updated
02/23/2023
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