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General NPI Number Information
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NPI Number | 1609909944
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Entity Type | Organization
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Legal Business Name | AMARILLO GASTROENTEROLOGY ASSOCIATES
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1901 MEDI PARK DR SUITE 1030
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City | AMARILLO
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State | TX
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Zip | 79106-2110
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Country | US
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Telephone | 806-356-2754
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Fax | 806-356-2820
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Provider Business Mailing Address
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Address Line | PO BOX 51508
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City | AMARILLO
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State | TX
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Zip | 79159-1508
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Country | US
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Telephone | 806-356-2754
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Fax | 806-356-2820
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MALWINDER SINGH SIDHU
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Credential | M.D.
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Telephone | 806-365-2754
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | J8130
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License Number State | TX
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