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General NPI Number Information
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NPI Number | 1851618375
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Entity Type | Organization
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Legal Business Name | AMARILLO INTERVENTIONAL PAIN MANAGEMENT PA
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Dates
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Enumeration Date | 04/23/2010
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Last Update Date | 06/24/2015
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Provider Practice Location Address
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Address Line | 7901 SW 34TH AVE
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City | AMARILLO
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State | TX
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Zip | 79121-1057
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Country | US
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Telephone | 806-352-7431
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Fax |
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Provider Business Mailing Address
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Address Line | 3411 UNIVERSITY AVE
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City | LUBBOCK
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State | TX
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Zip | 79413-2438
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Country | US
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Telephone | 806-796-0507
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Fax | 806-799-6908
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. VICTOR MARCUS TAYLOR
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Credential | M.D.
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Telephone | 806-577-0440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | M8378
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | M8378
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License Number State | TX
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