Doctor Name: | KEVIN COLE |
NPI Number: | 1003150186 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 761618 |
Business Practice Address: | 3502 9th St Suite 430 Lubbock, TX - 794153300 |
Business Phone Number: | 8067441171 |
Business Fax Number: | |
Mailing Address: | 3502 9th St, Suite 430 LUBBOCK |
State: | TX |
Postal Code: | 794153300 |
Phone Number: | 8067441171 |
Fax Number: | |
NPI Enumeration Date: | 11/15/2012 |
NPI Last Update Date: | 11/15/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 761618 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |