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Dr Gerald W Pennie
Adolescent and Children Mental Health Clinic/Center in Lubbock, Texas
NPI 1235667601

Dr Gerald W Pennie is an Adolescent and Children Mental Health Clinic/Center based in Lubbock, TX and is specialized in Adolescent and Children Mental Health. Dr Gerald W Pennie practices in Lubbock, TX. The NPI Number for Dr Gerald W Pennie is 1235667601 and holds a License No. 72286 (Texas).

The current practice location address for Dr Gerald W Pennie is 3805 22Nd St Ste 1C, Lubbock, TX and can be reached out via phone at 713-417-6057 and via fax at 713-417-6057. You can also correspond with Dr Gerald W Pennie through the mailing address at 2735 GENOA AVE APT 2B, LUBBOCK, TX - 79407-7848 (mailing address contact number: 713-417-6057).

Location: 3805 22Nd St Ste 1C, Lubbock, TX, 79407-7848
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1235667601
Provider Name
Dr Gerald W Pennie
Credential
Provider Entity Type
Organization
Address
3805 22Nd St Ste 1C, Lubbock, TX, 79407-7848
Phone Number
713-417-6057
Fax Number
713-417-6057
Provider Enumeration Date
05/31/2017
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
3805 22Nd St Ste 1C
City
Lubbock
State
Texas
Zip
79410-1142
Phone Number
713-417-6057
Fax Number
713-417-6057
person
Provider Business Mailing Address Details
Address
2735 Genoa Ave Apt 2B
City
Lubbock
State
Texas
Zip
79407-7848
Phone Number
713-417-6057
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Mental Health (Including Community Mental Health Center)
Taxonomy
261QM0801X
License No.
72286 (Texas)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adult Mental Health
Taxonomy
261QM0850X
License No.
72286 (Texas)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
person
Provider's Taxonomy Details 3
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adolescent and Children Mental Health
Taxonomy
261QM0855X
License No.
72286 (Texas)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
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