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Individual

JACK K WILLIS JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
4060 MEDICAL PARK DR # A, ODESSA, TX 79765-2233
(432) 582-2882
(432) 582-2884
Mailing address
4060 MEDICAL PARK DR, ODESSA, TX 79765-2233
(432) 582-2882
(432) 582-2884

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA05950
TX

Other

Enumeration date
10/21/2008
Last updated
12/12/2025
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