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General NPI Number Information
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NPI Number | 1588953517
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Entity Type | Organization
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Legal Business Name | HARRY J. CAZZOLA M.D. P.A.
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Dates
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Enumeration Date | 03/30/2011
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Last Update Date | 04/30/2014
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Provider Practice Location Address
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Address Line | 1920 MEDI PARK DR STE 4
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City | AMARILLO
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State | TX
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Zip | 79106-2111
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Country | US
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Telephone | 806-355-8902
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Fax | 806-355-5592
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Provider Business Mailing Address
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Address Line | 1920 MEDI PARK DR STE 4
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City | AMARILLO
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State | TX
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Zip | 79106-2111
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Country | US
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Telephone | 806-355-8902
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Fax | 806-355-5592
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Authorized Official
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Title or Position | OWNER
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Name | MR. HARRY J CAZZOLA
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Credential | MD
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Telephone | 806-355-8902
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | G0966
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License Number State | TX
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