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General NPI Number Information
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NPI Number | 1336012046
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Entity Type | Organization
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Legal Business Name | PHILLIP W. JANSEN, PLLC
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Dates
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Enumeration Date | 09/29/2025
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Last Update Date | 09/29/2025
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Provider Practice Location Address
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Address Line | 540 W 15TH ST
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City | HEREFORD
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State | TX
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Zip | 79045-2820
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Country | US
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Telephone | 803-364-7512
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Fax |
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Provider Business Mailing Address
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Address Line | 3312 DANVERS DR STE B
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City | AMARILLO
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State | TX
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Zip | 79106-3500
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Country | US
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Telephone | 803-847-2175
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PHILLIP WAYNE JANSEN
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Credential | DO
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Telephone | 803-847-2175
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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