Healthcare Provider Details

I. General information

NPI: 1669632972
Provider Name (Legal Business Name): WATSON P ROYE MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2008
Last Update Date: 03/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1911 PORT LN
AMARILLO TX
79106-2470
US

IV. Provider business mailing address

1911 PORT LN
AMARILLO TX
79106-2470
US

V. Phone/Fax

Practice location:
  • Phone: 806-331-6283
  • Fax: 806-331-6285
Mailing address:
  • Phone: 806-331-6283
  • Fax: 806-331-6285

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberG5559
License Number StateTX

VIII. Authorized Official

Name: WATSON P ROYE JR.
Title or Position: PRESIDENT
Credential: MD
Phone: 806-331-6283