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Organization
TEXAS TECH UNIVERSITY HEALTH SERVICES CENTER-AMARILLO
Active
Organization
TEXAS TECH UNIVERSITY HEALTH SERVICES CENTER-AMARILLO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DENISE RUSSELL CPCS (CREDENTIALING COORDINATOR)
(806) 354-5495
Entity
Organization
Contact information
Practice address
206 NE 7TH, AMARILLO, TX 79101
(806) 374-9964
(806) 374-2945
Mailing address
1400 WALLACE BLVD, ATTN CREDENTIALING, AMARILLO, TX 79106
(806) 354-5585
(806) 356-4673
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
TX
Other
Enumeration date
08/31/2006
Last updated
08/22/2020
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