Organization
BSA AMARILLO DIAGNOSTIC CLINIC INC
Active
Organization
BSA AMARILLO DIAGNOSTIC CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN C PETROVICH (SVP)
(615) 296-3000
Entity
Organization
Contact information
Practice address
6700 W 9TH AVE, AMARILLO, TX 79106-1701
(806) 358-0200
(806) 356-5590
Mailing address
1 BURTON HILLS BLVD, SUITE 250, NASHVILLE, TN 37215-6293
(615) 295-3000
(615) 296-6011
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
339696201
—
TX
Enumeration date
11/18/2013
Last updated
10/19/2015
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