Organization Active NPI

Lubbock Cardiology Clinic, PA

  • Cardiovascular Disease Physician
  • Lubbock, TX
National Provider Identifier
1972607034
Registry record updated May 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
LUBBOCK CARDIOLOGY CLINIC, PA
Practice address
3819 24TH St
Lubbock, TX 79410-1829
Phone
(806) 797-7000
Fax
(806) 797-7055
NPI assigned
Sep 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2011

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

Authorized official

Name
Stephanie Wells
Title
Office Manager
Phone
(806) 797-7002

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X Primary
Clinical Cardiac Electrophysiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0001X
Interventional Cardiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0011X

Addresses

Primary practice location

3819 24TH St
Lubbock, TX 79410-1829

Mailing address

3819 24TH St
Lubbock, TX 79410-1829
Phone (806) 797-7000

Other identifiers 1

IdentifierTypeStateIssuer
153423201MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110531000524 TX Part B Supplier - Clinic/Group Practice 3375720303 Receives reassigned benefits from 2 practitioners
Practice locations: Lubbock, TX

National Provider Directory

National Provider Directory

Locations

4412 6th St
Lubbock, TX 79416
Phone (806) 451-5005

3819 24th St
Lubbock, TX 79410
Phone (806) 792-2847

Practitioners & affiliated clinicians

Practitioners 5

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": "1157932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306800000000",
    "number": "1972607034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3819 24TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101829",
            "telephone_number": "806-797-7000",
            "fax_number": "806-797-7055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3819 24TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101829",
            "telephone_number": "806-797-7000",
            "fax_number": "806-797-7055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUBBOCK CARDIOLOGY CLINIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-11",
        "last_updated": "2011-05-31",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "806-797-7002"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "153423201",
            "state": "TX"
        }
    ],
    "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 May 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.