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General NPI Number Information
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NPI Number | 1295790707
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Entity Type | Individual
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Provider Name | DANIEL JAY HENDRICK MD
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Gender | Male
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Dates
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Enumeration Date | 04/18/2006
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Last Update Date | 12/26/2012
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Provider Practice Location Address
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Address Line | 1805 POINT WEST PARKWAY SUITE 100
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City | AMARILLO
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State | TX
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Zip | 79124
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Country | US
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Telephone | 806-418-8620
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Fax | 806-418-8626
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Provider Business Mailing Address
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Address Line | 1805 POINT WEST PARKWAY SUITE 100
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City | AMARILLO
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State | TX
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Zip | 79124
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Country | US
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Telephone | 806-418-8620
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Fax | 806-418-8626
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 00025682
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | M7257
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 25682
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License Number State | AL
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Taxonomy #4
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | M7257
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License Number State | TX
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