Lubbock Radiology LP

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

LUBBOCK RADIOLOGY LP

Practice address

3707 21St St
Lubbock, TX 79410-1219

Phone

(806) 792-2767

Fax

(806) 791-6709

NPI assigned

Jun 24, 2005

Organization subpart

No

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

Authorized official

Name

Monty Medanich

Title

Coo

Phone

(806) 792-2767

Specialties & licenses 3

Addresses

Other identifiers 6

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jin-Shone Leo, M.D.

  • Diagnostic Radiology Physician
  • Lubbock, TX
  • NPI 1689679748
  NPD (past)
• David Stuart Muff, M.D.

  • Diagnostic Radiology Physician
  • Lubbock, TX
  • NPI 1578568960
  NPD (past)
• Richard Luis Pajares, M.D.

  • Diagnostic Radiology Physician
  • Lubbock, TX
  • NPI 1558367870
  NPD (past)
• Scott Cranston Porter, M.D.

  • Diagnostic Radiology Physician
  • Lubbock, TX
  • NPI 1134124894
  NPD (past)
• Todd Randall Samuels, M.D.

  • Diagnostic Radiology Physician
  • Lubbock, TX
  • NPI 1316942014
  NPD (past)

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635897600000",
    "number": "1245236132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2160",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794082160",
            "telephone_number": "806-792-2767",
            "fax_number": "806-791-6709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3707 21ST ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101219",
            "telephone_number": "806-792-2767",
            "fax_number": "806-791-6709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUBBOCK RADIOLOGY LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-24",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A",
        "authorized_official_last_name": "MEDANICH",
        "authorized_official_first_name": "MONTY",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "806-792-2767"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "TX",
            "license": null,
            "primary": true
        },
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "1895212",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "470001572",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "J730",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "W6027",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRSTCARE",
            "identifier": "104497100",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "153651801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lubbock Physical Therapy, Inc (Physical Therapy Services of Lubbock)
• Lubbock Plastic Surgery Associates PA
• Lubbock Plastic Surgery Center, LP
• Lubbock Primary Care, PLLC
• Lubbock Psychiatry, PLLC.
• Lubbock Regional Mental Health Mental Retardation (Starcare Specialty Health System)
• Lubbock Regional Mental Health Mental Retardation
• Lubbock Regional MHMR Center
• Lubbock Regional MHMR Center
• Lubbock Regional MHMR Center

• Physiological Laboratory in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Physiological Laboratory in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.