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General NPI Number Information
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NPI Number | 1083062731
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Entity Type | Organization
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Legal Business Name | TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER
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Dates
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Enumeration Date | 06/02/2016
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Last Update Date | 06/02/2016
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Provider Practice Location Address
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Address Line | 1400 WALLACE BLVD
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City | AMARILLO
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State | TX
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Zip | 79106-1708
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Country | US
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Telephone | 806-414-9578
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Fax | 806-414-9733
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Provider Business Mailing Address
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Address Line | 1400 WALLACE BLVD
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City | AMARILLO
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State | TX
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Zip | 79106-1708
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Country | US
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Telephone | 806-414-9578
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Fax | 806-414-9733
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Authorized Official
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Title or Position | PROFESSOR PEDIATRIC DEPT, RESEARCH
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Name | THOMAS WRIGHT HALE
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Credential | R.PH, PH.D.
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Telephone | 806-414-9578
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1100X
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Taxonomy Name | Research Clinic/Center
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License Number | 17912
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License Number State | TX
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