Provider Demographics
NPI:1770516775
Name:RICHARD A PARTIN
Entity type:Organization
Organization Name:RICHARD A PARTIN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:BOBBY
Authorized Official - Middle Name:ROYCE
Authorized Official - Last Name:LOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:RRT-NPS/RPSGT
Authorized Official - Phone:806-745-2551
Mailing Address - Street 1:PO BOX 3987
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79452-3987
Mailing Address - Country:US
Mailing Address - Phone:806-745-2551
Mailing Address - Fax:806-745-5171
Practice Address - Street 1:517 82ND ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79404-6337
Practice Address - Country:US
Practice Address - Phone:806-745-2551
Practice Address - Fax:806-745-5171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0034595332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX016046701Medicaid
TX0409780001Medicare NSC
TXC08441410Medicare PIN