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General NPI Number Information
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NPI Number | 1548923949
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Entity Type | Individual
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Provider Name | MR. CORY JAMES PICKETT
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Gender | Male
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Dates
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Enumeration Date | 10/21/2021
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Last Update Date | 11/23/2022
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Provider Practice Location Address
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Address Line | 7625 FLEMING AVE
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City | AMARILLO
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State | TX
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Zip | 79106-1801
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Country | US
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Telephone | 806-353-0125
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Fax |
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Provider Business Mailing Address
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Address Line | 7625 FLEMING AVE
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City | AMARILLO
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State | TX
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Zip | 79106-1801
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Country | US
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Telephone | 806-353-0125
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 953862
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License Number State | TX
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