Provider Demographics
NPI:1225746423
Name:MOUNTAIN PASS PLLC
Entity Type:Organization
Organization Name:MOUNTAIN PASS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:KYLE
Authorized Official - Last Name:SHEETS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-729-3445
Mailing Address - Street 1:1602 AVENUE Q
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79401-4732
Mailing Address - Country:US
Mailing Address - Phone:806-729-3445
Mailing Address - Fax:
Practice Address - Street 1:859 ALDERSON ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSON
Practice Address - State:WV
Practice Address - Zip Code:25661-3215
Practice Address - Country:US
Practice Address - Phone:304-235-2500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty