Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.
TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER LUBBOCK
Complete NPI Record 1972552263
Pediatrics in Lubbock, TX
Active since May 06, 2006
Complete NPI Dataset
This page contains the complete raw NPPES record for Texas Tech University Health Sciences Center Lubbock (NPI 1972552263), a pediatrics organization in Lubbock, TX. All 49 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.
Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, Markdown or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.
Registry File Document Utilities
- NPI: 1972552263 Field 1/49
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Entity Type Code: 2 Field 2/49
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Employer Identification Number EIN: Not available Field 3/49
- The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
- Provider Organization Name Legal Business Name: TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER LUBBOCK Field 4/49
- The name of the organization provider. If the provider is an organization, this is the legal business name.
- Provider First Line Business Mailing Address: PO BOX 27476 Field 5/49
- The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
- Provider Business Mailing Address City Name: SALT LAKE CITY Field 6/49
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: UT Field 7/49
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
- Provider Business Mailing Address Postal Code: 841270476 Field 8/49
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
- Provider Business Mailing Address Country Code If outside U S : US Field 9/49
- The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
- Provider Business Mailing Address Telephone Number: 8067434263 Field 10/49
- The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
- Provider Business Mailing Address Fax Number: 8067432787 Field 11/49
- The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
- Provider First Line Business Practice Location Address: 3601 4TH ST Field 12/49
- The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Business Practice Location Address City Name: LUBBOCK Field 13/49
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: TX Field 14/49
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 794300002 Field 15/49
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Practice Location Address Country Code If outside U S : US Field 16/49
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 8067437337 Field 17/49
- The telephone number associated with the location address of the provider being identified.
- Provider Business Practice Location Address Fax Number: 8067432314 Field 18/49
- The fax number associated with the location address of the provider being identified.
- Authorized Official Last Name: SWETT Field 21/49
- The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
- Authorized Official First Name: BRETT Field 22/49
- The first name of the authorized official.
- Authorized Official Title or Position: ASSISTANT DEAN OF FINANCE ADMINISTR Field 23/49
- The title or position of the authorized official.
- Authorized Official Telephone Number: 8067431830 Field 24/49
- The 10-position telephone number of the authorized official.
- Healthcare Provider Taxonomy Code 1: 208000000X Field 25/49
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Healthcare Provider Primary Taxonomy Switch 1: Y Field 26/49
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Other Provider Identifier 1: 084585102 Field 27/49
- An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
- Other Provider Identifier Type Code 1: 05 Field 28/49
- A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
- Other Provider Identifier State 1: TX Field 29/49
- The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
- Other Provider Identifier 2: 140327131 Field 30/49
- An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
- Other Provider Identifier Type Code 2: 05 Field 31/49
- A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
- Other Provider Identifier State 2: TX Field 32/49
- The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
- Other Provider Identifier 3: 084585101 Field 33/49
- An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
- Other Provider Identifier Type Code 3: 05 Field 34/49
- A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
- Other Provider Identifier State 3: TX Field 35/49
- The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
- Other Provider Identifier 4: CD9207 Field 36/49
- An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
- Other Provider Identifier Type Code 4: 01 Field 37/49
- A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
- Other Provider Identifier State 4: TX Field 38/49
- The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
- Other Provider Identifier Issuer 4: RAILROAD MEDICARE Field 39/49
- The name of the organization, agency, or health plan that assigned the additional provider identifier. This identifies who issued the number linked to Other Provider Identifier 1 (for example, a state Medicaid agency, Medicare, or a private insurance company).
- Other Provider Identifier 5: 00QQ71 Field 40/49
- An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
- Other Provider Identifier Type Code 5: 01 Field 41/49
- A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
- Other Provider Identifier State 5: TX Field 42/49
- The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
- Other Provider Identifier Issuer 5: BC/BS Field 43/49
- The name of the organization, agency, or health plan that assigned the additional provider identifier. This identifies who issued the number linked to Other Provider Identifier 1 (for example, a state Medicaid agency, Medicare, or a private insurance company).
- Other Provider Identifier 6: G1217 Field 44/49
- An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
- Other Provider Identifier Type Code 6: 05 Field 45/49
- A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
- Other Provider Identifier State 6: NM Field 46/49
- The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
- Is Organization Subpart: N Field 47/49
- Indicates whether the provider is a subpart of a larger organization. This is a single-character code: "Y" means the entity is an organizational subpart, while "N" means it is not. Subparts typically include hospital departments, clinics, or other distinct units that fall under a parent organization.
- Healthcare Provider Taxonomy Group 1: 193200000X MULTI-SPECIALTY GROUP Field 48/49
- Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.
Secondary Practice Locations 19
The first line of the secondary practice location address of the provider being identified. For providers with more than one physical location, this is a secondary practice location address. This address cannot include a Post Office box.
4101 22nd Pl
Location 1/19Lubbock, TX 79410-1121 · Phone (806) 725-8000 · Fax (806) 725-4847
4302 Princeton St
Location 2/19Lubbock, TX 79415-1304 · Phone (806) 749-2222 · Fax (806) 740-8570
4430 S Loop 289
Location 3/19Lubbock, TX 79414-5005 · Phone (806) 743-7770 · Fax (806) 743-7769
602 Indiana Ave
Location 4/19Lubbock, TX 79415-3364 · Phone (806) 743-7337
3502 9th St Ste 130
Location 5/19Lubbock, TX 79415-3367 · Phone (806) 743-1188
4015 22nd Pl
Location 6/19Lubbock, TX 79410-1119 · Phone (806) 725-6000 · Fax (806) 723-7753
4102 24th St Ste 507
Location 7/19Lubbock, TX 79410-1805 · Phone (806) 743-7700 · Fax (806) 743-7703
6610 Quaker Ave
Location 8/19Lubbock, TX 79413-5938 · Phone (806) 743-4270 · Fax (806) 743-9097
4102 24th St Ste 205
Location 9/19Lubbock, TX 79410-1801 · Phone (806) 725-4840 · Fax (806) 725-4847
400 Rosalind Redfern Grover Pkwy Ste 251
Location 10/19Midland, TX 79701-5857 · Phone (806) 743-7700 · Fax (806) 743-7703
3001 John Ben Shepperd Pkwy
Location 11/19Odessa, TX 79762-8126 · Phone (806) 743-7700 · Fax (806) 743-7703
4102 24th St Ste 504
Location 12/19Lubbock, TX 79410-1805 · Phone (806) 743-7700 · Fax (806) 743-7703
3001 Jbs Pkwy
Location 13/19Odessa, TX 79762-8126 · Phone (806) 743-7700 · Fax (806) 743-7703
417 N Akron Ave
Location 14/19Lubbock, TX 79415-2333 · Phone (806) 766-1304
6630 Quaker Ave
Location 15/19Lubbock, TX 79413-5900 · Phone (806) 743-7660 · Fax (806) 743-7670
802 N 2nd St
Location 16/19Floydada, TX 79235-2142 · Phone (806) 983-5701
1400 S Coulter St Ste 1400
Location 17/19Amarillo, TX 79106-1786 · Phone (806) 410-9800
1400 S Coulter St # 1400
Location 18/19Amarillo, TX 79106-1786 · Phone (806) 410-9800 · Fax (806) 354-5689
4004 82nd St
Location 19/19Lubbock, TX 79423-2065 · Phone (806) 743-7660
Other Provider Identifiers 6
Legacy and payer-issued identifiers reported to the NPPES registry for this provider.
084585102 Medicaid
Identifier 1/6State: TX
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
140327131 Medicaid
Identifier 2/6State: TX
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
084585101 Medicaid
Identifier 3/6State: TX
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
CD9207 Other
Identifier 4/6State: TX · Issuer: Railroad Medicare
Other: An additional provider identifier that does not correspond to any of the other defined identifier type categories.
Other: An additional provider identifier that does not correspond to any of the other defined identifier type categories.
00QQ71 Other
Identifier 5/6State: TX · Issuer: Bc/bs
Other: An additional provider identifier that does not correspond to any of the other defined identifier type categories.
Other: An additional provider identifier that does not correspond to any of the other defined identifier type categories.
G1217 Medicaid
Identifier 6/6State: NM
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
No registry entries match your active lookup criteria.
