Individual
KIMBERLY A WAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1901 MEDI PARK, STE 2050, AMARILLO, TX 79106-2110
(806) 355-3352
Mailing address
PO BOX 3780, AMARILLO, TX 79116-3780
(806) 355-3352
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G9398
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117938406
—
TX
01
—
126494104
FIRSTCARE
—
05
—
200023170A
—
OK
05
—
52927211
—
NM
01
—
8F7704
BLUE CROSS
TX
01
—
MDG9398
WORKERS COMPENSATION
TX
Enumeration date
03/29/2006
Last updated
06/11/2008
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