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General NPI Number Information
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NPI Number | 1558432591
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Entity Type | Organization
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Legal Business Name | WEST TEXAS MULTICARE
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | #7 MEDICAL DRIVE
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City | AMARILLO
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State | TX
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Zip | 79106
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Country | US
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Telephone | 806-358-3595
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Fax | 806-358-4647
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Provider Business Mailing Address
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Address Line | #7 MEDICAL DRIVE
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City | AMARILLO
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State | TX
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Zip | 79106
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Country | US
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Telephone | 806-358-3595
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Fax | 806-358-4647
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Authorized Official
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Title or Position | DIRECTOR OF CHIROPRACTIC
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Name | DR. JON DARIN BLACKWELL
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Credential | DC
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Telephone | 806-358-3595
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC8667
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License Number State | TX
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