Healthcare Provider Details

I. General information

NPI: 1255012779
Provider Name (Legal Business Name): AMARILLO WEST TEXAS EMERGENCY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2023
Last Update Date: 07/15/2024
Certification Date: 07/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2105 S WESTERN ST
AMARILLO TX
79109-1571
US

IV. Provider business mailing address

1535 WEST LOOP S STE 300
HOUSTON TX
77027-0003
US

V. Phone/Fax

Practice location:
  • Phone: 806-502-6468
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: TASEER BADAR
Title or Position: CEO
Credential:
Phone: 806-310-5086