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Organization
WYATT CLINIC, P.A.
Active
Organization
WYATT CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CAROLYN SUE HURT (CPMSM, CPCS)
(806) 355-8900
Entity
Organization
Contact information
Practice address
1411 E AMARILLO BLVD, AMARILLO, TX 79107-5555
(806) 351-7200
(806) 351-7274
Mailing address
1411 E. AMARILLO BLVD., AMARILLO, TX 79107-5555
(806) 354-1015
(806) 351-7274
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
168039901
—
TX
Enumeration date
08/31/2006
Last updated
03/30/2012
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