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General NPI Number Information
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NPI Number | 1356394894
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Entity Type | Organization
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Legal Business Name | OPEN AIR MRI OF AMARILLO, LP
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 07/09/2010
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Provider Practice Location Address
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Address Line | 7400 WALLACE BLVD
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City | AMARILLO
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State | TX
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Zip | 79106-1818
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Country | US
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Telephone | 806-353-8333
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Fax | 806-353-8332
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Provider Business Mailing Address
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Address Line | 7400 WALLACE BLVD
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City | AMARILLO
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State | TX
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Zip | 79106-1818
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Country | US
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Telephone | 806-353-8333
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Fax | 806-353-8332
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WALWORTH BURGE
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Credential | MD
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Telephone | 806-353-8333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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