Organization
TEXAS TECH UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALEXIS DOUGHERTY (RESIDENT/PGY2)
(832) 341-9832
Entity
Organization
Contact information
Practice address
5710 4TH ST, 3026, LUBBOCK, TX 79416-4214
(832) 341-9832
Mailing address
5710 4TH ST, 3026, LUBBOCK, TX 79416-4214
Taxonomy
Speciality
Code
Description
License number
State
261QV0200X
VA Clinic/Center
Primary
ENHL320
TX
Other
Enumeration date
07/08/2010
Last updated
07/08/2010
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