Individual
MR. TREVOR JERROD FUGATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGACNP-BC
Contact information
Practice address
602 INDIANA AVE, LUBBOCK, TX 79415-3364
(806) 775-8200
Mailing address
6914 96TH ST, LUBBOCK, TX 79424-8802
(806) 544-5185
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
885559
TX
363LC0200X
Critical Care Medicine Nurse Practitioner
Primary
1084498
TX
Other
Enumeration date
04/25/2022
Last updated
02/09/2023
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