Basic Information
| Provider Information | |||||||||
| NPI: | 1194713222 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HANCOCK | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 64864 | ||||||||
| Address2: | |||||||||
| City: | LUBBOCK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 79490 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8067852045 | ||||||||
| FaxNumber: | 8067850872 | ||||||||
| Practice Location | |||||||||
| Address1: | 3502 9TH ST | ||||||||
| Address2: | SUITE 360 | ||||||||
| City: | LUBBOCK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 794153300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8067610747 | ||||||||
| FaxNumber: | 8067610751 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/12/2005 | ||||||||
| LastUpdateDate: | 12/09/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | H8676 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
ID Information
| ID | Type | State | Issuer | Description | 114476100 | 01 | TX | FIRSTCARE COMMERCIAL | OTHER | 47220571 | 05 | NM | MEDICAID | 53297 | 01 | NM | PRESBYTERIAN COMMERCIAL | OTHER | D002 | 01 | TX | TRIWEST | OTHER | 100846160A | 05 | OK | MEDICAID | 114476106 | 05 | TX | MEDICAID | 128124808 | 05 | TX | MEDICAID | 86959X | 01 | TX | HMO BLUE | OTHER | 0097JP | 01 | TX | BCBS | OTHER | 53297 | 05 | NM | MEDICAID | 8G6720 | 01 | TX | BC/BS | OTHER | 128124807 | 05 | TX | MEDICAID | 128124809 | 05 | TX | MEDICAID |