Organization Active NPI

Lubbock Plastic Surgery Associates PA

  • Specialist
  • Lubbock, TX
National Provider Identifier
1235243395
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
F1173 Issued in TX
Legal business name
LUBBOCK PLASTIC SURGERY ASSOCIATES PA
Practice address
4404 6TH St
Lubbock, TX 79416-4732
Phone
(806) 793-5545
Fax
(806) 795-1411
NPI assigned
Aug 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

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

Authorized official

Name
Dr. Ronald J North, MD
Title
Owner
Phone
(806) 793-5545

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X F1173 TX Primary

Addresses

Primary practice location

4404 6TH St
Lubbock, TX 79416-4732

Mailing address

4404 6TH St
Lubbock, TX 79416-4732
Phone (806) 793-5545

Other identifiers 1

IdentifierTypeStateIssuer
163203601MedicaidTX

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1235243395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4404 6TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794164732",
            "telephone_number": "806-793-5545",
            "fax_number": "806-795-1411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4404 6TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794164732",
            "telephone_number": "806-793-5545",
            "fax_number": "806-795-1411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUBBOCK PLASTIC SURGERY ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "NORTH",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "806-793-5545",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "F1173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "163203601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jun 18, 2008; 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.