Provider Demographics
NPI:1407975220
Name:LUBBOCK ORTHOPEDIC ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:LUBBOCK ORTHOPEDIC ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:GAYLON
Authorized Official - Middle Name:B
Authorized Official - Last Name:SEAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-795-9559
Mailing Address - Street 1:PO BOX 94088
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79493-4088
Mailing Address - Country:US
Mailing Address - Phone:806-795-9559
Mailing Address - Fax:806-791-5253
Practice Address - Street 1:5009 UNIVERSITY AVE
Practice Address - Street 2:SUITE G
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79413-4431
Practice Address - Country:US
Practice Address - Phone:806-795-9559
Practice Address - Fax:806-791-5253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE8895174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00SN91Medicare PIN