Individual
AMY LEIGH STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1400 WALLACE BLVD, AMARILLO, TX 79106-1708
(806) 414-9970
(806) 351-3783
Mailing address
1400 WALLACE BLVD, AMARILLO, TX 79106-1708
(806) 414-9970
(806) 351-3783
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
R7906
TX
2084P0800X
Psychiatry Physician
58205
MI
2084P0800X
Psychiatry Physician
Primary
R7906
TX
2084P0802X
Addiction Psychiatry Physician
R7906
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
387244201
—
TX
05
—
94677794
—
NM
Enumeration date
05/03/2013
Last updated
11/05/2018
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