Provider Demographics
NPI:1548288475
Name:LUBBOCK CHILDREN'S HEALTH CLINIC
Entity type:Organization
Organization Name:LUBBOCK CHILDREN'S HEALTH CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-472-7229
Mailing Address - Street 1:PO BOX 12103
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79452-2103
Mailing Address - Country:US
Mailing Address - Phone:806-787-9904
Mailing Address - Fax:
Practice Address - Street 1:302 N UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79415-2318
Practice Address - Country:US
Practice Address - Phone:806-787-9904
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty