Organization
AMARILLO PEDIATRIC ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHU SHUM MD (MANAGER)
(806) 358-8526
Entity
Organization
Contact information
Practice address
1801 HALSTEAD ST, AMARILLO, TX 79106-1830
(806) 358-8526
(806) 358-0179
Mailing address
1801 HALSTEAD ST, AMARILLO, TX 79106-1811
(806) 358-8526
(806) 358-0179
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0014CK
BLUE CROSS
TX
01
—
109449
SUPERIOR HEALTH PLAN
TX
Enumeration date
05/01/2006
Last updated
11/30/2007
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