Provider Demographics
NPI:1952908253
Name:LUBBOCK CEC SFSER ACQUISITION LLC
Entity Type:Organization
Organization Name:LUBBOCK CEC SFSER ACQUISITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:RADLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-591-2256
Mailing Address - Street 1:2360 DEAN WAY
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-1379
Mailing Address - Country:US
Mailing Address - Phone:713-591-2256
Mailing Address - Fax:
Practice Address - Street 1:7007 INDIANA AVE
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79413-6113
Practice Address - Country:US
Practice Address - Phone:806-701-4141
Practice Address - Fax:817-421-0036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-08
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care