Provider Demographics
NPI:1649401050
Name:QUAKER MEDICAL LP
Entity type:Organization
Organization Name:QUAKER MEDICAL LP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:K
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-723-8700
Mailing Address - Street 1:4302 PRINCETON ST UNIT B
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79415-1307
Mailing Address - Country:US
Mailing Address - Phone:806-723-8700
Mailing Address - Fax:806-723-8723
Practice Address - Street 1:4302 PRINCETON ST UNIT B
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79415-1307
Practice Address - Country:US
Practice Address - Phone:806-723-8700
Practice Address - Fax:806-723-8723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-03
Last Update Date:2011-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
670070Medicare Oscar/Certification