Organization Active NPI

Lubbock Dermatology and Skin Cancer Center

  • Dermatology Physician
  • Lubbock, TX
National Provider Identifier
1295721066
Registry record updated Apr 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
LUBBOCK DERMATOLOGY AND SKIN CANCER CENTER
Practice address
3601 22ND St
Lubbock, TX 79410-1309
Phone
(806) 796-7193
Fax
(806) 796-0034
NPI assigned
Sep 27, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2019

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

Authorized official

Name
Richard Howard Hope, MDNPI 1457346819
Title
Partner
Phone
(806) 796-7193

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

3601 22ND St
Lubbock, TX 79410-1309

Mailing address

3601 22ND St
Lubbock, TX 79410-1309
Phone (806) 796-7193

Other practice location 1

5103 98th St Ste 200
Lubbock, TX 79424-7530
Phone (806) 796-7193

Other names 1

  • Lubbock Dermatology Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060419000195 TX Part B Supplier - Clinic/Group Practice 9032128053 Receives reassigned benefits from 9 practitioners
Practice locations: Lubbock, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D0963936Lubbock Dermatology & Skin Cancer Ctr3601 22ND Street, Lubbock, TX 79410ComplianceJul 26, 2026
45D2167858Lubbock Dermatology & Skin Cancer Center5103 98TH St Suite 200, Lubbock, TX 79424ComplianceMay 5, 2027

National Provider Directory

National Provider Directory

Locations

3601 22nd St
Lubbock, TX 79410
Phone (806) 796-7193

5103 98th St
Ste 200
Lubbock, TX 79424
Phone (806) 796-7193

Practitioners & affiliated clinicians

Practitioners 10

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

NPI Registry JSON

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555459200000",
    "number": "1295721066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 22ND ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101309",
            "telephone_number": "806-796-7193",
            "fax_number": "806-796-0034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 22ND ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101309",
            "telephone_number": "806-796-7193",
            "fax_number": "806-796-0034"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5103 98th St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794247530",
            "country_code": "US",
            "telephone_number": "806-796-7193",
            "fax_number": "806-796-0034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LUBBOCK DERMATOLOGY AND SKIN CANCER CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-27",
        "last_updated": "2019-04-17",
        "status": "A",
        "authorized_official_last_name": "HOPE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "HOWARD",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "806-796-7193",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lubbock Dermatology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lubbock Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.