# WEST TEXAS REGENERATIVE MEDICINE CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750654984
- **Authorized official:** KEITH E DYER MD (OWNER-PROVIDER)
- **Authorized official phone:** (806) 367-8719

## Contact information

- **Practice address:** 1701 5TH AVE, STE A, CANYON, TX 79015-3834
- **Practice address phone:** (806) 655-4878
- **Practice address fax:** (806) 655-8790
- **Mailing address:** 3501 S SONCY, STE 1001, AMARILLO, TX 79119-3834
- **Mailing address phone:** (806) 367-8719
- **Mailing address fax:** (806) 418-4329

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | — | NULL | — |
| 111N00000X | Chiropractor | — | — | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | K5914 | TX | Yes |

## Other

- **Enumeration date:** 02/19/2012
- **Last updated:** 07/17/2013