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General NPI Number Information
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NPI Number | 1659245272
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Entity Type | Organization
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Legal Business Name | TLC PEDIATRICS OF AMARILLO
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Dates
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Enumeration Date | 10/06/2025
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 3501 S SONCY RD STE #102
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City | AMARILLO
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State | TX
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Zip | 79119
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Country | US
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Telephone | 806-353-7900
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Fax | 806-353-8321
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Provider Business Mailing Address
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Address Line | 3501 S SONCY RD STE #102
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City | AMARILLO
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State | TX
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Zip | 79119
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Country | US
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Telephone | 806-353-7900
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Fax | 806-353-8321
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Authorized Official
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Title or Position | OWNER
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Name | DR. TAGHREED MAAYTAH
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Credential | MD
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Telephone | 806-353-7900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number |
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License Number State |
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