| Texas Tech Uhsc Psychiatry | |
|
1400 Wallace Blvd Amarillo TX 79106-1708 | |
| (806) 414-9970 | |
| (806) 351-3783 |
| Full Name | Texas Tech Uhsc Psychiatry |
|---|---|
| Speciality | Psychologist |
| Location | 1400 Wallace Blvd, Amarillo, Texas |
| Authorized Official Name and Position | Debra L Lee (UNIT MANAGER) |
| Authorized Official Contact | 8064149565 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Texas Tech Uhsc Psychiatry 1400 S Coulter St Amarillo TX 79106-1786 Ph: (806) 414-9562 | Texas Tech Uhsc Psychiatry 1400 Wallace Blvd Amarillo TX 79106-1708 Ph: (806) 414-9970 |
| NPI Number | 1255365375 |
|---|---|
| Provider Enumeration Date | 07/11/2006 |
| Last Update Date | 03/06/2023 |
| Certification Date | 03/06/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255365375 | NPI | - | NPPES |
| G4070 | Medicaid | NM | |
| 100759180B | Medicaid | OK | |
| 084567901 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| 291U00000X | Clinical Medical Laboratory | (* (Not Available)) | Secondary |
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