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General NPI Number Information
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NPI Number | 1104124304
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Entity Type | Organization
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Legal Business Name | AMARILLO VISION SPECIALISTS, P.A.
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Dates
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Enumeration Date | 03/11/2011
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Last Update Date | 05/15/2023
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Provider Practice Location Address
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Address Line | 3700 E INTERSTATE 40
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City | AMARILLO
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State | TX
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Zip | 79103
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Country | US
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Telephone | 806-372-1977
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Fax |
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Provider Business Mailing Address
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Address Line | 4505 ABERDEEN DR
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City | AMARILLO
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State | TX
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Zip | 79119-6429
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Country | US
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Telephone | 806-640-4224
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHAUNA M THORNHILL
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Credential | O.D.
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Telephone | 806-372-1977
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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