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COVENANT HIGH PLAINS SURGERY CENTER LLC NPI 1871608216


NPI Information

NPI: 1871608216
Provider Name: COVENANT HIGH PLAINS SURGERY CENTER, LLC

Doing Business As: COVENANT HIGH PLAINS SURGERY CENTER

Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 45D1059123

Address:
3610 22ND STREET
LUBBOCK, TX
ZIP 79410
Phone: (806) 776-4772
Get Directions

COVENANT HIGH PLAINS SURGERY CENTER, LLC is an ambulatory surgical clinic center in Lubbock, TX. COVENANT HIGH PLAINS SURGERY CENTER, LLC NPI is 1871608216. The provider is registered as an organization entity type.
The provider Is Doing Business As Covenant High Plains Surgery Center.

The provider's business location address is:

3610 22ND STREET
LUBBOCK, TX
ZIP 79410-307
Phone: (806) 776-4772
Fax: (806) 776-4777

The provider's authorized official is Gregg Miller .
The authorized official title is Authorized Official and has the following contact phone number (610) 644-8900.

The CLIA number assigned to this NPI record is 45D1059123 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/19/2006 and was last updated on 7/1/2021.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QA1903XClinic/CenterAmbulatory SurgicalTEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1186066001MEDICAIDTEXAS

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.