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General NPI Number Information
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NPI Number | 1366557506
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Entity Type | Organization
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Legal Business Name | SOUTHWEST NEUROSCIENCE AND SPINE CENTER PA
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 09/01/2023
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Provider Practice Location Address
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Address Line | 705 QUAIL CREEK DR
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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 | 806-353-6400
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Fax | 806-358-6766
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Provider Business Mailing Address
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Address Line | 705 QUAIL CREEK DR
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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 | 806-353-6400
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Fax | 806-358-6766
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Authorized Official
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Title or Position | BILLING/CREDENTIALING MANAGER
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Name | LINDY LEE
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Credential |
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Telephone | 806-353-6400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State |
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