Organization
PATRICK PROFFER, M.D.,P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICK J PROFFER M.D. (OWNER)
(806) 352-1185
Entity
Organization
Contact information
Practice address
1611 WALLACE BLVD, AMARILLO, TX 79106-1763
(806) 352-1185
Mailing address
1611 WALLACE BLVD, AMARILLO, TX 79106-1763
(806) 352-1185
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
M0532
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
174819602
—
TX
Enumeration date
02/07/2008
Last updated
07/25/2013
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