NPIMap

Organization Active NPI

Ttuhsc Managed Care

  • Prison Health Clinic/Center
  • Lubbock, TX
National Provider Identifier
1104490556
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prison Health Clinic/CenterTaxonomy code 261QP2400X
Legal business name
TTUHSC MANAGED CARE
Practice address
1215 Avenue J
Lubbock, TX 79401-4038
Phone
(806) 743-3818
NPI assigned
May 19, 2021
Organization subpart
Yes
Parent organization
TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 24, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Will Rodriguez
Title
Managed Care Executive Director
Phone
(806) 743-3280

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prison Health Clinic/Center 261QP2400X Primary

Addresses

Primary practice location

1215 Avenue J
Lubbock, TX 79401-4038

Mailing address

1215 Avenue J
Lubbock, TX 79401-4038
Phone (806) 743-3818

Other names 1

  • TTUHSC Managed Care Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Endocrine Laboratory7 organizations share this tax ID, including this one
Part of
Endocrine Laboratory

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1215 Avenue J
Lubbock, TX 79401
Phone (806) 743-2686

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1621382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621814400000",
    "number": "1104490556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 AVENUE J",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794014038",
            "telephone_number": "806-743-3818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 AVENUE J",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794014038",
            "telephone_number": "806-743-3818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TTUHSC MANAGED CARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER",
        "enumeration_date": "2021-05-19",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "WILL",
        "authorized_official_title_or_position": "MANAGED CARE EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "806-743-3280",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Prison Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TTUHSC Managed Care",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.