Healthcare Provider Details

I. General information

NPI: 1346585809
Provider Name (Legal Business Name): BSA HARRINGTON PHYSICIANS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2012
Last Update Date: 12/07/2021
Certification Date: 12/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1751 WALLACE BLVD
AMARILLO TX
79106-1711
US

IV. Provider business mailing address

PO BOX 840048
DALLAS TX
75284-0048
US

V. Phone/Fax

Practice location:
  • Phone: 806-212-4673
  • Fax: 806-212-0057
Mailing address:
  • Phone: 806-212-5079
  • Fax: 806-212-6278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN C PETROVICH
Title or Position: SVP
Credential:
Phone: 615-296-3000