Provider Demographics
NPI:1669418547
Name:UMC PHYSICIANS
Entity type:Organization
Organization Name:UMC PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR, BUSINESS SERVICE
Authorized Official - Prefix:
Authorized Official - First Name:MARCO
Authorized Official - Middle Name:
Authorized Official - Last Name:GUARDIOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-761-0333
Mailing Address - Street 1:5219 CITY BANK PKWY
Mailing Address - Street 2:SUITE 160
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79407-3544
Mailing Address - Country:US
Mailing Address - Phone:806-761-0333
Mailing Address - Fax:806-785-7685
Practice Address - Street 1:5219 CITY BANK PKWY STE 135
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79407-3595
Practice Address - Country:US
Practice Address - Phone:806-761-0333
Practice Address - Fax:806-785-7685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-21
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NML0376Medicaid
TX079877902Medicaid
TXCD2498OtherRAILROAD MEDICARE
TX00U84UOtherBCBS
TX079877902Medicaid
NM800521162Medicare PIN