Provider Demographics
NPI:1932333150
Name:AFHCPH (1), LP
Entity Type:Organization
Organization Name:AFHCPH (1), LP
Other - Org Name:PREMIER HEALTHCARE CENTER WEST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER, CEO, PA-C
Authorized Official - Prefix:
Authorized Official - First Name:GUSTAVO
Authorized Official - Middle Name:ALFONSO
Authorized Official - Last Name:BENDECK
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:806-771-3565
Mailing Address - Street 1:4833 50TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79414-3418
Mailing Address - Country:US
Mailing Address - Phone:806-771-3565
Mailing Address - Fax:806-771-3560
Practice Address - Street 1:4833 50TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79414-3418
Practice Address - Country:US
Practice Address - Phone:806-771-3565
Practice Address - Fax:806-771-3560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-04
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care