MEDICARE: AMARILLO PAIN ASSOCIATES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208VP0000X	Pain Medicine Physician

General Provider Information

NPI Number	:	1063500379
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMARILLO PAIN ASSOCIATES

Provider Business Mailing Address
First Line	:	1901 MEDI PARK DR
Second Line	:	SUITE 2002
City	:	AMARILLO
State	:	TX
Zip	:	79106-2110
Country	:	US
Telephone Number	:	806-353-4699
Fax Number	:	806-353-4551

Provider Business Practice Location Address
First Line	:	1901 MEDI PARK DR
Second Line	:	SUITE 2002
City	:	AMARILLO
State	:	TX
Zip	:	79106-2110
Country	:	US
Telephone Number	:	806-353-4699
Fax Number	:	806-353-4551

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. THOMAS MERRIMAN
Credential	:	M.D.
Telephone Number	:	806-353-4699

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	04/08/2014

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