| NAME |
LUBBOCK |
| STATE |
TEXAS |
| STREET ADDR. 1 |
3510 4TH ST |
| CITY |
LUBBOCK |
| ZIP |
79415-9998 |
| OFFICIAL VA NAME |
LUBBOCK OUTPATIENT CLINIC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
LUBBOCK VA CLINIC |
| ST. ADDR. 1 (MAILING) |
6104 AVENUE Q SOUTH DRIVE |
| CITY (MAILING) |
LUBBOCK |
| STATE (MAILING) |
TEXAS |
| ZIP (MAILING) |
79412-3700 |
| EFFECTIVE DATE/TIME |
-
- 2007-01-08 00:00:00
- STATUS: ACTIVE
- NPI: 1790746188
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
CENTRAL |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
504BY |
| IDENTIFIER |
-
- CODING SYSTEM: NPI
- ID: 1790746188
-
- CODING SYSTEM: VASTANUM
- ID: 504BY
-
- CODING SYSTEM: CLIA
- ID: 45D0987891
|
