Provider Demographics
NPI:1699052811
Name:TEXAS TECH THERAPEUTIC RIDING CENTER
Entity type:Organization
Organization Name:TEXAS TECH THERAPEUTIC RIDING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-785-2564
Mailing Address - Street 1:PO BOX 42141
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79409-2141
Mailing Address - Country:US
Mailing Address - Phone:806-785-2564
Mailing Address - Fax:806-792-4683
Practice Address - Street 1:5712 COUNTY ROAD 1500
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79407-5412
Practice Address - Country:US
Practice Address - Phone:806-785-2564
Practice Address - Fax:806-792-4683
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TEXAS TECH UNIVERSITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-11-16
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)