Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. ETHAN BERNELL DALLEY, M.D.
Active Sole ProprietorDR. ETHAN BERNELL DALLEY, M.D. is a Pain Medicine (PM&R) healthcare provider located in LUBBOCK, Texas. NPI 1780818112 is currently active in the NPPES registry. Verify at CMS.
Pain Medicine (PM&R) · LUBBOCK, TX
Registration Details
- NPI Number
- 1780818112
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 13, 2009 (17.293278857559 yrs)
- Last Updated
- Jul 21, 2022
- License
-
P9063 (TX)
- Sole Proprietor
- Yes
Practice Information
- Address
-
3419 22ND STLUBBOCK, TX, 79410Browse TX providers · Browse ZIP 79410
- Phone
- 8067963000
- Fax
- 8067963006
- Primary Specialty
-
Pain Medicine (PM&R)
2081P2900X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.