Cornelia S Deriese MD PA
Organization Active NPI Obstetrics & Gynecology Physician · Lubbock, TX
NPI 1053789990 · NPPES record last updated Sep 9, 2015
Key facts
- NPI
- 1053789990
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- L6348 (TX)
- Legal business name
- CORNELIA S DERIESE MD PA
- Practice address
- 3814 24TH St
Lubbock, TX 79410-1814 - Phone
- (806) 553-7950
- Fax
- (623) 777-4593
- NPI assigned
- Sep 9, 2015
- Organization subpart
- No
Authorized official
- Name
- Dr. Cornelia S Deriese, MD PA
- Title
- Owner
- Phone
- (888) 753-5988
Practitioners 1
-
Cornelia Selma De Riese, MD, PHD, MBA
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician |
207V00000X | L6348 | TX | Yes |
Addresses
Primary practice location
3814 24TH St
Lubbock, TX 79410-1814
Mailing address
2708 27TH St
Lubbock, TX 79410-2229
Phone (888) 753-5988
Other providers in Lubbock, TX
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- Lisa Michele Cordova
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- Cornerstone OB-GYN PLLC
- Cornerstone Physical Medicine & Rehabilitation, PC
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- Brian Adrian Cornwell
All providers in Lubbock, TX · Obstetrics & Gynecology Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 9, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.