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General NPI Number Information
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NPI Number | 1861507964
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Entity Type | Organization
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Legal Business Name | AMARILLO NEPHROLOGY ASSOCIATES, P.A.
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 02/07/2021
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Provider Practice Location Address
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Address Line | 1805 POINT WEST PKWY STE 100
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City | AMARILLO
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State | TX
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Zip | 79124-2166
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Country | US
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Telephone | 806-418-8620
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Fax | 806-418-8626
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Provider Business Mailing Address
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Address Line | 1805 POINT WEST PKWY SUITE 100
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City | AMARILLO
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State | TX
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Zip | 79124-2165
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Country | US
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Telephone | 806-418-8620
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Fax | 806-418-8626
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Authorized Official
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Title or Position | PRESIDENT
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Name | DANIEL HENDRICK
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Credential | M.D.
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Telephone | 806-418-8620
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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