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Organization
TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER AMARILLO
Active
Organization
TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER AMARILLO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE RUSSELL CPCS (CREDENTIALING COORDINATOR)
(806) 354-5495
Entity
Organization
Contact information
Practice address
1400 S COULTER ST, AMARILLO, TX 79106-1786
(806) 354-5688
(806) 354-5672
Mailing address
1400 WALLACE BLVD, AMARILLO, TX 79106-1708
(806) 354-5585
(806) 356-4673
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
2084P0800X
Psychiatry Physician
—
—
208600000X
Surgery Physician
—
—
225100000X
Physical Therapist
—
—
291U00000X
Clinical Medical Laboratory
—
—
Other
Enumeration date
08/11/2006
Last updated
11/11/2013
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