Healthcare Provider Details
I. General information
NPI: 1316947609
Provider Name (Legal Business Name): AMARILLO ENDOSCOPY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/28/2005
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6833 PLUM CREEK DR
AMARILLO TX
79124-1602
US
IV. Provider business mailing address
6833 PLUM CREEK DR
AMARILLO TX
79124-1602
US
V. Phone/Fax
- Phone: 806-467-9820
- Fax: 806-467-9743
- Phone: 806-467-9820
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | 007790 |
| License Number State | TX |
VIII. Authorized Official
Name:
JILL
FINKE
Title or Position: OFFICER/AUTHORIZED OFFICIAL
Credential:
Phone: 210-478-5430