MEDICARE: ROBERT MICHAEL WARD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TH0100X	Health Service Psychologist	12198	TX

General Provider Information

NPI Number	:	1154443232
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT MICHAEL WARD

Provider Business Mailing Address
First Line	:	8010 FOUTS PL
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79121-1018
Country	:	US
Telephone Number	:	806-352-1449
Fax Number	:

Provider Business Practice Location Address
First Line	:	US HWY 60 AT FM 2373
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79120-0020
Country	:	US
Telephone Number	:	806-477-5228
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2007
Last Update Date	:	07/08/2007

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Directions to “ ROBERT MICHAEL WARD ” Practice Location

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