Covenant Health System

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

License

000465 Issued in TX

Legal business name

COVENANT HEALTH SYSTEM

Practice address

3615 19TH St
Lubbock, TX 79410-1203

Phone

(806) 725-1011

Fax

(806) 723-6180

NPI assigned

Jan 12, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Richard Parks

Title

Ceo

Phone

(806) 725-1011

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Covenant Medical Center Doing business as

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312416000000",
    "number": "1457401036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1201",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794081201",
            "telephone_number": "806-725-1011",
            "fax_number": "806-723-6180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3615 19TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101203",
            "telephone_number": "806-725-1011",
            "fax_number": "806-723-6180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-12",
        "last_updated": "2011-08-04",
        "status": "A",
        "authorized_official_last_name": "PARKS",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "806-725-1011",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "TX",
            "license": "000465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "085980302",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Covenant Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Covenant Health Center
• Covenant Health Partners, Inc.
• Covenant Health System
• Covenant Health System
• Covenant Health System
• Covenant Health System
• Covenant Health System
• Covenant Health System
• Covenant Health System
• Covenant Health System

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Lubbock, TX
• Providers in Lubbock, TX by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2011; 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.