Provider Demographics
NPI:1053458026
Name:TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER LUBBOCK
Entity type:Organization
Organization Name:TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER LUBBOCK
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT DEAN OF FINANCE ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:
Authorized Official - Last Name:MAJORS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-743-1830
Mailing Address - Street 1:PO BOX 5865
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79408-5865
Mailing Address - Country:US
Mailing Address - Phone:806-743-2898
Mailing Address - Fax:806-743-2787
Practice Address - Street 1:3601 4TH ST
Practice Address - Street 2:STE 2A100
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79430-0002
Practice Address - Country:US
Practice Address - Phone:806-743-2898
Practice Address - Fax:806-743-2787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX084588503Medicaid
TX084588504Medicaid
TX084588506Medicaid
TXCD9207OtherRAILROAD MEDICARE
TX4224050001Medicare NSC