Individual provider Active NPI

Dustin Ray Fontana

  • Critical Care Medicine Registered Nurse
  • Lubbock, TX
National Provider Identifier
1336058106
Registry record updated Sep 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Registered NurseTaxonomy code 163WC0200X
License
962631 Issued in TX
Practice address
4002 22ND PL
Lubbock, TX 79410-1145
Phone
(432) 213-5684
NPI assigned
Sep 5, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 962631 TX Primary

Addresses

Primary practice location

4002 22ND PL
Lubbock, TX 79410-1145

Mailing address

5412 93Rd St
Lubbock, TX 79424-4324

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1788566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788566400000",
    "number": "1336058106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5412 93RD ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794244324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4002 22ND PL",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101145",
            "telephone_number": "432-213-5684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTANA",
        "first_name": "DUSTIN",
        "middle_name": "RAY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-09-05",
        "last_updated": "2026-09-05",
        "certification_date": "2026-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "TX",
            "license": "962631",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.