Provider Demographics
NPI:1386973758
Name:COMISKEY, GEORGE E (LCDC)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:E
Last Name:COMISKEY
Suffix:
Gender:M
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4630 50TH ST
Mailing Address - Street 2:SUITE 509
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79414-3521
Mailing Address - Country:US
Mailing Address - Phone:806-771-8808
Mailing Address - Fax:806-771-8809
Practice Address - Street 1:4630 50TH ST
Practice Address - Street 2:SUITE 509
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79414-3521
Practice Address - Country:US
Practice Address - Phone:806-771-8808
Practice Address - Fax:806-771-8809
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-15
Last Update Date:2009-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9029101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)