Individual
CHARLES J PYBUS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
8003 W 34TH AVE, AMARILLO, TX 79121-1065
(806) 354-2500
(806) 354-9732
Mailing address
8003 W 34TH AVE, AMARILLO, TX 79121-1065
(806) 354-2500
(806) 354-9732
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
13676
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
857045
UNITED CONCORDIA PROVIDER
TX
01
—
D13676
BCBS PROVIDER ID#
TX
Enumeration date
05/11/2006
Last updated
07/08/2007
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