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Individual

DR. DANIEL JAY HENDRICK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1805 POINT WEST PARKWAY, SUITE 100, AMARILLO, TX 79124
(806) 418-8620
(806) 418-8626
Mailing address
1805 POINT WEST PARKWAY, SUITE 100, AMARILLO, TX 79124
(806) 418-8620
(806) 418-8626

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
00025682
AL
207R00000X
Internal Medicine Physician
M7257
TX
207RN0300X
Nephrology Physician
25682
AL
207RN0300X
Nephrology Physician
Primary
M7257
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009989245
AL
01
752684668
BCBS
TX
01
8L2468
MEDICARE PTAN
TX
05
93481586
NM
Enumeration date
04/18/2006
Last updated
12/26/2012
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