Provider Demographics
NPI:1265810642
Name:TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER - SON - LUBBOCK
Entity type:Organization
Organization Name:TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER - SON - LUBBOCK
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCMURRY
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, RN, NEA-BC
Authorized Official - Phone:806-743-9571
Mailing Address - Street 1:301 40TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79404-2746
Mailing Address - Country:US
Mailing Address - Phone:806-743-9355
Mailing Address - Fax:806-743-9363
Practice Address - Street 1:1749 PINE ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-3043
Practice Address - Country:US
Practice Address - Phone:325-696-0600
Practice Address - Fax:325-676-3873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-18
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)