Organization
BSA PHYSICIANS GROUP INC
Active
Other names
BSA Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
EILEEN T HARPOLE (DIRECTOR)
(806) 212-6965
Entity
Organization
Contact information
Practice address
3501 S SONCY RD STE 148, AMARILLO, TX 79119
(806) 212-6965
(806) 212-6278
Mailing address
PO BOX 840026, DALLAS, TX 75284-0026
(806) 212-6965
(806) 212-6278
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00R06W
GROUP BCBS
TX
01
—
266489
GROUP MEDICARE
TX
05
—
325874101
—
TX
Enumeration date
09/29/2005
Last updated
05/17/2018
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