Organization
BSA HARRINGTON PHYSICIANS INC
Active
Parent organization
BSA PHYSICIAN HOLDING COMPANY LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
BSA PHYSICIAN HOLDING COMPANY LLC
Authorized official
STEPHEN C PETROVICH (SVP)
(615) 296-3000
Entity
Organization
Contact information
Practice address
1751 WALLACE BLVD, AMARILLO, TX 79106-1711
(806) 212-4673
(806) 212-0057
Mailing address
PO BOX 840048, DALLAS, TX 75284-0048
(806) 212-5079
(806) 212-6278
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
136269114
—
TX
01
—
330222YNR6
MEDICARE
TX
Enumeration date
12/10/2012
Last updated
12/07/2021
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