Provider Demographics
NPI:1659720944
Name:HORAK, JEREMY MICHAEL (DO)
Entity Type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:MICHAEL
Last Name:HORAK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3601 4TH ST
Mailing Address - Street 2:MS 6211
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79430-6211
Mailing Address - Country:US
Mailing Address - Phone:806-743-2978
Mailing Address - Fax:806-743-1599
Practice Address - Street 1:3601 4TH ST
Practice Address - Street 2:MS 6211
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79430-6211
Practice Address - Country:US
Practice Address - Phone:806-743-2978
Practice Address - Fax:806-743-1599
Is Sole Proprietor?:No
Enumeration Date:2016-06-07
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXBP10056159207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine