MEDICARE: CHILDREN'S HEALTHCARE ASSOCIATES, LLP

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	208000000X	Pediatrics Physician	K1129	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831226430
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHILDREN'S HEALTHCARE ASSOCIATES, LLP

Provider Business Mailing Address
First Line	:	1901 MEDI PARK DR STE 2001
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79106-2108
Country	:	US
Telephone Number	:	806-468-4350
Fax Number	:	806-468-4351

Provider Business Practice Location Address
First Line	:	1901 MEDI PARK DR STE 2001
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79106-2108
Country	:	US
Telephone Number	:	806-468-4350
Fax Number	:	806-468-4351

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. CARMEN M WERNER
Credential	:	MD
Telephone Number	:	806-468-4350

Provider Enumeration Date	:	02/28/2007
Last Update Date	:	08/25/2020

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Directions to “CHILDREN'S HEALTHCARE ASSOCIATES, LLP ” Practice Location

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