Provider Demographics
NPI:1124049390
Name:LUBBOCK MINOR EMERGENCY CENTER ASSOCIATES
Entity type:Organization
Organization Name:LUBBOCK MINOR EMERGENCY CENTER ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:SOSTENES
Authorized Official - Last Name:CHAVEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-797-4357
Mailing Address - Street 1:5015 UNIVERSITY AVE
Mailing Address - Street 2:B-1
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79413-4427
Mailing Address - Country:US
Mailing Address - Phone:806-797-4357
Mailing Address - Fax:806-797-0124
Practice Address - Street 1:5015 UNIVERSITY AVE
Practice Address - Street 2:B-1
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79413-4427
Practice Address - Country:US
Practice Address - Phone:806-797-4357
Practice Address - Fax:806-797-0124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty