MEDICARE: MR. CORY JAMES PICKETT

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	363LF0000X	Family Nurse Practitioner	1105889	TX

General Provider Information

NPI Number	:	1548923949
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CORY JAMES PICKETT

Provider Business Mailing Address
First Line	:	5701 TIME SQ STE 120
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79119-1179
Country	:	US
Telephone Number	:	806-821-2020
Fax Number	:

Provider Business Practice Location Address
First Line	:	5701 TIME SQ STE 120
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79119-1179
Country	:	US
Telephone Number	:	806-821-2020
Fax Number	:

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

Provider Enumeration Date	:	10/21/2021
Last Update Date	:	04/14/2026

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Directions to “ MR. CORY JAMES PICKETT ” Practice Location

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