Healthcare Provider Details

I. General information

NPI: 1326029703
Provider Name (Legal Business Name): RONALD THANE MORGAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 05/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 S COULTER ST BUILDING B
AMARILLO TX
79106-1710
US

IV. Provider business mailing address

1600 S COULTER ST BUILDING B
AMARILLO TX
79106-1710
US

V. Phone/Fax

Practice location:
  • Phone: 806-355-4900
  • Fax: 806-355-4903
Mailing address:
  • Phone: 806-355-4900
  • Fax: 806-355-4903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberK1264
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: