Organization
TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER AT AMARILLO
Active
Other names
Radiology Lab
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DENISE RUSSELL CPCS (CREDENTIALING COORDINATOR)
(806) 354-5495
Entity
Organization
Contact information
Practice address
1400 S COULTER ST, AMARILLO, TX 79106-1786
(806) 354-5700
Mailing address
1400 WALLACE BLVD, AMARILLO, TX 79106-1708
(806) 354-5700
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
R05258
TX
2085R0202X
Diagnostic Radiology Physician
Primary
R05258
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R05258
CERTIFICATE OF X-RAY REGI
TX
Enumeration date
01/18/2007
Last updated
09/11/2025
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