TTUHSC MANAGED CARE NPI 1104490556

NPI Information

NPI: 1104490556
Provider Name: TTUHSC MANAGED CARE
Classification: Clinic/Center - 261QP2400X
Entity Type: Organization

Specialization: Prison Health

CLIA Number: 45D0722752

Address:
1215 AVENUE J
LUBBOCK, TX
ZIP 79401
Phone: (806) 743-3818
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TTUHSC MANAGED CARE is a prison health clinic center in Lubbock, TX. TTUHSC MANAGED CARE NPI is 1104490556. The provider is registered as an organization entity type.

The provider's business location address is:

1215 AVENUE J
LUBBOCK, TX
ZIP 79401-038
Phone: (806) 743-3818

The provider's authorized official is Will Rodriguez .
The authorized official title is Managed Care Executive Director and has the following contact phone number (806) 743-3280.

The CLIA number assigned to this NPI record is 45D0722752 - prison with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/19/2021 and was last updated on 5/24/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2400X	Clinic/Center	Prison Health			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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