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Organization
AMARILLO COLONOSCOPY CENTER LP
Active
Organization
AMARILLO COLONOSCOPY CENTER LP
Active
Other names
Panhandle Endoscopy Center LP
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMBASIVA RAO MARUPUDI M.D. (ADMINISTRATOR)
(806) 367-8537
Entity
Organization
Contact information
Practice address
800 QUAIL CREEK DRIVE, SUITE 102, AMARILLO, TX 79124-1634
(806) 367-8537
(806) 367-8538
Mailing address
800 QUAIL CREEK DRIVE, SUITE 102, AMARILLO, TX 79124-1634
(806) 367-8537
(806) 367-8538
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
008144
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07690690
AETBA INS CO
—
01
—
HH039A
BLUE CROSS BLUE SHIELD
TX
01
—
P00300440
RAILROAD MEDICARE
—
Enumeration date
07/02/2006
Last updated
01/22/2014
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