Basic Information
| Provider Information | |||||||||
| NPI: | 1538130737 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | LUBBOCK TEXAS HIGHLAND MEDICAL CENTER, L.P. | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | HIGHLAND COMMUNITY HOSPITAL | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2412 50TH STREET | ||||||||
| Address2: | |||||||||
| City: | LUBBOCK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 79412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8067884060 | ||||||||
| FaxNumber: | 8067884278 | ||||||||
| Practice Location | |||||||||
| Address1: | 2412 50TH ST | ||||||||
| Address2: | |||||||||
| City: | LUBBOCK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 794122504 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8067884100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/27/2006 | ||||||||
| LastUpdateDate: | 01/14/2009 | ||||||||
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| AuthorizedOfficialLastName: | MEEKS | ||||||||
| AuthorizedOfficialFirstName: | RODNEY | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | V.P. OPERATIONS | ||||||||
| AuthorizedOfficialTelephone: | 8067884060 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 000013 | TX | Y | Hospitals | General Acute Care Hospital |
ID Information
| ID | Type | State | Issuer | Description | 050209 | 01 | TX | AETNA | OTHER | 628232264 | 01 | NM | MEDICAID NM | OTHER | 135238706 | 05 | TX | MEDICAID | HH0114 | 01 | TX | BLUE CROSS PROVIDER | OTHER | 7523902391 | 01 | TX | PCCA | OTHER |