Organization
TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER @ LUBBOCK
Active
Other names
DME - Ortho
Organization subpart
No
Provider details
NPI number
Authorized official
BRENT MAGERS (CEO)
(806) 743-1830
Entity
Organization
Contact information
Practice address
3601 4TH ST, LUBBOCK, TX 79430-9906
(806) 743-2475
(806) 743-1290
Mailing address
PO BOX 27476, SALT LAKE CITY, UT 84127-0476
(806) 743-4263
(806) 743-2787
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XP3100X
Pediatric Orthopaedic Surgery Physician
—
—
207XS0106X
Orthopaedic Hand Surgery Physician
—
—
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
—
—
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
207XX0801X
Orthopaedic Trauma Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CD9207
RAILROAD MEDICARE
TX
Enumeration date
03/21/2011
Last updated
10/01/2019
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