Provider Demographics
NPI:1992761829
Name:FLATHOUSE, ROSS (PA)
Entity type:Individual
Prefix:
First Name:ROSS
Middle Name:
Last Name:FLATHOUSE
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:5219 CITY BANK PKWY
Mailing Address - Street 2:STE 35
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79407-3544
Mailing Address - Country:US
Mailing Address - Phone:806-785-7676
Mailing Address - Fax:806-785-7685
Practice Address - Street 1:3502 9TH ST
Practice Address - Street 2:STE 260
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79415-3300
Practice Address - Country:US
Practice Address - Phone:806-792-8185
Practice Address - Fax:806-792-9180
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2021-03-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXPA03996363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q11176Medicare UPIN
8B4674Medicare ID - Type Unspecified