Individual
DR. ETHAN BERNELL DALLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3419 22ND ST, LUBBOCK, TX 79410
(806) 796-3000
(806) 796-3006
Mailing address
3419 22ND ST, LUBBOCK, TX 79410-1334
(806) 796-3000
(806) 796-3006
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
P9063
TX
Other
Enumeration date
05/13/2009
Last updated
07/21/2022
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