Texas Tech University Health Sciences Center Lubbock
Organization Active NPI Pediatrics Physician · Lubbock, TX
NPI 1972552263 · NPPES record last updated Jul 28, 2026
Key facts
- NPI
- 1972552263
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pediatrics Physician 208000000X
- Legal business name
- TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER LUBBOCK
- Practice address
- 3601 4TH St
Lubbock, TX 79430-0002 - Phone
- (806) 743-7337
- Fax
- (806) 743-2314
- NPI assigned
- May 6, 2006
- Organization subpart
- No
Authorized official
- Name
- Brett Swett
- Title
- Assistant Dean of Finance Administr
- Phone
- (806) 743-1830
Other NPIs on the same Medicare enrollment 23
Practitioners 99
-
Fatma Aboulnasr, MD
-
Mohamad M Al-Rahawan, M.D.
-
Charla Beth Allen, M.D.
-
Jodie Rae Archer, FNP
-
Mary O Baiyeri, MD
-
Benedicto Cortes Baronia, M.D.
-
Erin Kelly Barr, M.D.
-
Tara Bearden, MSN, APRN, FNP-C
-
Nancy Louise Beck, M.D.
-
Brynn Claryce Bednarz, PA-C
-
Michael Bourgeois, M.D.
-
Audra Bowman, M.D.
-
Melissa Bowman, PPCNP-BC
-
Stacy Clinton, M.D.
-
Carole E Conser, M.D.
-
Caleb John Cook, M.D.
-
Emily Gena Copeland, MSN, RN, CPNP-PC
-
Lisa Michele Cordova, FNP-C
-
Malorie Ruth Cortez, FNP-C
-
Shakisha Crockett, MSN,FNP-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110318000468 | TX | Part B Supplier - Clinic/Group Practice | 4385549674 |
Receives reassigned benefits from 692 practitioners 23 other NPIs on this enrollment This NPI is an additional NPI on the enrollment |
National Provider Directory
Locations
1400 S Coulter St
Ste 1400
Amarillo, TX 79106
Phone (806) 410-9800
6610 Quaker Ave
Lubbock, TX 79413
Phone (806) 743-4270
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician |
208000000X | Yes |
Addresses
Primary practice location
3601 4TH St
Lubbock, TX 79430-0002
Mailing address
PO Box 27476
Salt Lake City, UT 84127-0476
Phone (806) 743-4263
Other practice location 1
4102 24th St Ste 205
Lubbock, TX 79410-1801
Phone (806) 725-4840
Other practice location 2
6630 Quaker Ave
Lubbock, TX 79413-5900
Phone (806) 743-7660
Other practice location 3
1400 S Coulter St Ste 1400
Amarillo, TX 79106-1786
Phone (806) 410-9800
Other practice location 4
4102 24th St Ste 507
Lubbock, TX 79410-1805
Phone (806) 743-7700
Other practice location 5
4015 22nd Pl
Lubbock, TX 79410-1119
Phone (806) 725-6000
Other practice location 6
3502 9th St Ste 130
Lubbock, TX 79415-3367
Phone (806) 743-1188
Other practice location 7
602 Indiana Ave
Lubbock, TX 79415-3364
Phone (806) 743-7337
Other practice location 8
4430 S Loop 289
Lubbock, TX 79414-5005
Phone (806) 743-7770
Other practice location 9
400 Rosalind Redfern Grover Pkwy Ste 251
Midland, TX 79701-5857
Phone (806) 743-7700
Other practice location 10
4302 Princeton St
Lubbock, TX 79415-1304
Phone (806) 749-2222
Other practice location 11
3001 Jbs Pkwy
Odessa, TX 79762-8126
Phone (806) 743-7700
Other practice location 12
4101 22nd Pl
Lubbock, TX 79410-1121
Phone (806) 725-8000
Other practice location 13
4102 24th St Ste 504
Lubbock, TX 79410-1805
Phone (806) 743-7700
Other practice location 14
3001 John Ben Shepperd Pkwy
Odessa, TX 79762-8126
Phone (806) 743-7700
Other practice location 15
1400 S Coulter St # 1400
Amarillo, TX 79106-1786
Phone (806) 410-9800
Other practice location 16
802 N 2nd St
Floydada, TX 79235-2142
Phone (806) 983-5701
Other practice location 17
4004 82nd St
Lubbock, TX 79423-2065
Phone (806) 743-7660
Other practice location 18
417 N Akron Ave
Lubbock, TX 79415-2333
Phone (806) 766-1304
Other practice location 19
6610 Quaker Ave
Lubbock, TX 79413-5938
Phone (806) 743-4270
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 084585102 | Medicaid | TX | |
| 140327131 | Medicaid | TX | |
| 084585101 | Medicaid | TX | |
| CD9207 | Other | TX | RAILROAD MEDICARE |
| 00QQ71 | Other | TX | BC/BS |
| G1217 | Medicaid | NM |
Other providers in Lubbock, TX
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- Texas Tech University Health Sciences Center Lubbock
- Texas Tech University Health Sciences Center Lubbock
- Texas Tech University Health Sciences Center Lubbock
- Texas Tech University Health Sciences Center Lubbock
- Texas Tech University Health Sciences Center Lubbock
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All providers in Lubbock, TX · Pediatrics Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 28, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.