Healthcare Provider Details

I. General information

NPI: 1225421357
Provider Name (Legal Business Name): PANHANDLE EMERGENCY PHYSICIANS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2015
Last Update Date: 08/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 HELIUM RD
AMARILLO TX
79124-2365
US

IV. Provider business mailing address

22 HELIUM RD
AMARILLO TX
79124-2365
US

V. Phone/Fax

Practice location:
  • Phone: 866-488-4558
  • Fax: 405-607-1326
Mailing address:
  • Phone: 806-350-7744
  • Fax: 806-350-7776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. CARL PAETZOLD
Title or Position: MANAGER
Credential: M.D.
Phone: 806-350-7744