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General NPI Number Information
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NPI Number | 1811024474
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Entity Type | Organization
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Legal Business Name | AMARILLO AREA HEALTHCARE SPECIALIST
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1600 S COULTER ST C302
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City | AMARILLO
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State | TX
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Zip | 79106-1710
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Country | US
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Telephone | 806-354-2213
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Fax | 806-534-2112
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Provider Business Mailing Address
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Address Line | 1600 S COULTER ST C302
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City | AMARILLO
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State | TX
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Zip | 79106-1710
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Country | US
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Telephone | 806-354-2213
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Fax | 806-534-2112
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. WALTER J BRIDGES
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Credential | MD
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Telephone | 806-354-2213
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | H6071
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License Number State | TX
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