Organization
UMC PHYSICIAN NETWORK SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNETT AZZINARO (MANAGER, CENTRAL BUSINESS OPERATION)
(806) 761-0334
Entity
Organization
Contact information
Practice address
4004 82ND ST, LUBBOCK, TX 79423-1900
(806) 722-3150
(806) 722-4674
Mailing address
5219 CITY BANK PKWY, STE 35, LUBBOCK, TX 79407-3544
(806) 761-0334
(806) 722-2908
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
147762201
—
TX
01
—
FTX078
BLUE CROSS BLUE SHIELD
TX
Enumeration date
10/31/2007
Last updated
01/03/2012
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