Provider Demographics
NPI:1891444303
Name:WEST TEXAS ALLERGY, LUBBOCK, PLLC
Entity Type:Organization
Organization Name:WEST TEXAS ALLERGY, LUBBOCK, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:PATRIC
Authorized Official - Last Name:WOLBERT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:432-682-5385
Mailing Address - Street 1:5424 19TH ST STE 300
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79407-2164
Mailing Address - Country:US
Mailing Address - Phone:806-795-4391
Mailing Address - Fax:806-796-1354
Practice Address - Street 1:5424 19TH ST STE 300
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79407-2164
Practice Address - Country:US
Practice Address - Phone:806-795-4391
Practice Address - Fax:806-796-1354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-22
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty