Provider Demographics
NPI:1629274147
Name:TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER AT LUBBOCK
Entity Type:Organization
Organization Name:TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER AT LUBBOCK
Other - Org Name:TTUHSC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT DEAN OF FINANCE ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:
Authorized Official - Last Name:MAJORS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-743-1830
Mailing Address - Street 1:PO BOX 27476
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84127-0476
Mailing Address - Country:US
Mailing Address - Phone:806-743-4263
Mailing Address - Fax:806-743-2787
Practice Address - Street 1:3601 4TH ST
Practice Address - Street 2:STE 2A300
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79430-0002
Practice Address - Country:US
Practice Address - Phone:806-743-5678
Practice Address - Fax:806-743-5670
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER AT LUBBOCK
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-06-22
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and SpeechGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX084588507Medicaid
TXCD9207OtherRAILROAD MEDICARE
TX084588502Medicaid