Provider Demographics
NPI:1760917371
Name:DISCOVERY MEDICAL NETWORK TELEHEALTH, LLC
Entity Type:Organization
Organization Name:DISCOVERY MEDICAL NETWORK TELEHEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:YOST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-776-0602
Mailing Address - Street 1:2950 50TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79413-4326
Mailing Address - Country:US
Mailing Address - Phone:806-791-1591
Mailing Address - Fax:469-277-2797
Practice Address - Street 1:2950 50TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79413-4326
Practice Address - Country:US
Practice Address - Phone:806-791-1591
Practice Address - Fax:469-277-2797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-21
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty