Provider Demographics
NPI:1487635033
Name:SOUTH PLAINS PHYSICIANS ASSOCIATES LTD
Entity Type:Organization
Organization Name:SOUTH PLAINS PHYSICIANS ASSOCIATES LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:PITMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-688-1180
Mailing Address - Street 1:1510 SCURRY ST
Mailing Address - Street 2:STE C
Mailing Address - City:BIG SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:79720-4441
Mailing Address - Country:US
Mailing Address - Phone:877-688-1180
Mailing Address - Fax:432-264-9541
Practice Address - Street 1:1510 SCURRY ST
Practice Address - Street 2:STE C
Practice Address - City:BIG SPRING
Practice Address - State:TX
Practice Address - Zip Code:79720-4441
Practice Address - Country:US
Practice Address - Phone:877-688-1180
Practice Address - Fax:432-264-9541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-10
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
00416TMedicare ID - Type Unspecified