Provider Demographics
NPI:1588919674
Name:FERRIS, LEE TRAVIS (MD)
Entity type:Individual
Prefix:
First Name:LEE
Middle Name:TRAVIS
Last Name:FERRIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 4TH STREET PSYCHIATRY
Mailing Address - Street 2:STOP 8103
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79430-0001
Mailing Address - Country:US
Mailing Address - Phone:806-743-2800
Mailing Address - Fax:806-743-4250
Practice Address - Street 1:3601 4TH STREET PSYCHIATRY
Practice Address - Street 2:STOP 8103
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79430-0001
Practice Address - Country:US
Practice Address - Phone:806-743-2800
Practice Address - Fax:806-743-4250
Is Sole Proprietor?:No
Enumeration Date:2012-07-16
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program