Provider Demographics
NPI:1871595231
Name:PULMONARY ASSOCIATES OF LUBBOCK LLP
Entity type:Organization
Organization Name:PULMONARY ASSOCIATES OF LUBBOCK LLP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE
Authorized Official - Prefix:MS
Authorized Official - First Name:MARSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:STANLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-791-8484
Mailing Address - Street 1:3621 22ND ST.
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1302
Mailing Address - Country:US
Mailing Address - Phone:806-762-8066
Mailing Address - Fax:806-791-8499
Practice Address - Street 1:3621 22ND ST.
Practice Address - Street 2:SUITE 300
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1302
Practice Address - Country:US
Practice Address - Phone:806-762-8066
Practice Address - Fax:806-791-8498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-15
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX084081102Medicaid
TXFTS024Medicare PIN