Individual provider · NPI-1

Dr. Ethan Bernell Dalley, M.D.

Physical Medicine & Rehabilitation, Pain Medicine · Lubbock, TX

NPI number1780818112
StatusActive
Last updated in NPPESJul 21, 2022

Details

NPI
1780818112
Entity type
Individual (NPI-1)
Name
Dr. Ethan Bernell Dalley
Credential
M.D.
Sex
Male
Sole proprietor
Yes
Enumeration date
May 13, 2009
Last updated
Jul 21, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2081P2900X Physical Medicine & Rehabilitation, Pain MedicineP9063TXYes

Practice location

3419 22nd St
Lubbock, TX 79410

Phone 806-796-3000 · Fax 806-796-3006

Mailing address

3419 22nd St
Lubbock, TX 79410-1334

Phone 806-796-3000 · Fax 806-796-3006

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