Organization
NORTHWEST TEXAS PHYSICIAN GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN JOHANNESSEN (VICE PRESIDENT)
(610) 768-3300
Entity
Organization
Contact information
Practice address
1501 S COULTER ST, AMARILLO, TX 79106-1770
(610) 768-3300
Mailing address
367 S GULPH RD, KING OF PRUSSIA, PA 19406-3121
(610) 768-3300
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
11/04/2013
Last updated
11/04/2013
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