Basic Information
| Provider Information | |||||||||
| NPI: | 1962769588 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SIKES | ||||||||
| FirstName: | AMY | ||||||||
| MiddleName: | RICHELLE | ||||||||
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| Credential: | M.D, | ||||||||
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| Mailing Information | |||||||||
| Address1: | DEPARTMENT OF FAMILY AND COMMUNITY MEDICINE | ||||||||
| Address2: | 3601 4TH STREET, STOP 8143 | ||||||||
| City: | LUBBOCK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 794300001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8067432757 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | DEPARTMENT OF FAMILY AND COMMUNITY MEDICINE | ||||||||
| Address2: | 3601 4TH STREET, STOP 8143 | ||||||||
| City: | LUBBOCK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 794300001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8067432757 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/19/2012 | ||||||||
| LastUpdateDate: | 04/16/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 04/16/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | BP10043367 | TX | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | P8733 | TX | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.