Organization
CSK MEDICAL PARTNERS
Active
Other names
Lubbock Sports Medicine Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT THOMAS HENDRICKS (ADMINISTRATOR)
(806) 792-4329
Entity
Organization
Contact information
Practice address
4110 22ND PL, LUBBOCK, TX 79410-1122
(806) 792-4329
(806) 792-9466
Mailing address
4110 22ND PL, LUBBOCK, TX 79410-1122
(806) 792-4329
(806) 792-9466
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0080EH
BLUE CROSS/BLUE SHIELD OF TEXAS
—
01
—
0472270001
DMERC
—
Enumeration date
06/22/2006
Last updated
06/28/2012
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