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NPI 1720098064

NPI 1720098064 : JADE GARRETT ANDERSON M.D. : AMARILLO, TX

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General NPI Number Information
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    NPI Number           |    1720098064
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    Entity Type          |    Individual 
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    Provider Name        |    JADE GARRETT ANDERSON M.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/09/2006
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    Last Update Date     |    10/04/2024
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Provider Practice Location Address
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    Address Line         |    1826 POINT WEST PKWY 
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    City                 |    AMARILLO
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    State                |    TX
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    Zip                  |    79124-2167
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    Country              |    US
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    Telephone            |    806-358-8654
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    Fax                  |    806-356-8687
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Provider Business Mailing Address
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    Address Line         |    PO BOX 911230 
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    City                 |    DALLAS
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    State                |    TX
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    Zip                  |    75391-1230
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    Country              |    US
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    Telephone            |    972-997-8000
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    Fax                  |    972-234-0813
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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        |    207RX0202X
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    Taxonomy Name        |    Medical Oncology Physician
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    License Number       |    42135
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    License Number State |    MN
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Taxonomy #2
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    Taxonomy Code        |    207RX0202X
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    Taxonomy Name        |    Medical Oncology Physician
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    License Number       |    U8467
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    License Number State |    TX
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