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3300 I-40 E Suite 400 Amarillo TX 79103-4801 | |
(806) 379-9225 | |
(806) 379-7661 |
Full Name | |
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Speciality | Clinic/Center |
Location | 3300 I-40 E, Amarillo, Texas |
Authorized Official Name and Position | Ronald R Lacy (MEDICAL DIRECTOR) |
Authorized Official Contact | 8063799225 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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7118 I-40 W Suite 500 Amarillo TX 79106-2503 Ph: (806) 379-9225 | 3300 I-40 E Suite 400 Amarillo TX 79103-4801 Ph: (806) 379-9225 |
NPI Number | 1508051293 |
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Provider Enumeration Date | 09/06/2007 |
Last Update Date | 09/08/2015 |
Medicare PECOS PAC ID | 8729261623 |
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Medicare Enrollment ID | O20110331000127 |
Identifier | Type | State | Issuer |
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1508051293 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Paul Jew |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1114086253 PECOS PAC ID: 2062317670 Enrollment ID: I20031205000147 |
Provider Name | Cynthia Hewett |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1487853461 PECOS PAC ID: 5294913638 Enrollment ID: I20110707000052 |
Provider Name | Misty Lynn Lance |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1750838983 PECOS PAC ID: 7911282363 Enrollment ID: I20170327000793 |
Provider Name | Van Thy Nguyen |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1861003592 PECOS PAC ID: 4284051814 Enrollment ID: I20200827003313 |
Provider Name | Ximena Maria Gomez |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1740864628 PECOS PAC ID: 2860893328 Enrollment ID: I20210622002666 |
Provider Name | Melissa Moore |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1043883101 PECOS PAC ID: 9931503802 Enrollment ID: I20210814000187 |
Provider Name | Isela Venzor |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1710467303 PECOS PAC ID: 1355736216 Enrollment ID: I20220312000063 |
Provider Name | Virginie Mekemvou Zebaze |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1891518254 PECOS PAC ID: 8022544857 Enrollment ID: I20241204000343 |
Srinivas Pathapati, Mdpa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6833 Plum Creek Dr, Amarillo, TX 79124 Phone: 806-467-9820 Fax: 806-467-9743 | |
Eres Bella, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5215 S Coulter St Ste 200, Amarillo, TX 79119 Phone: 806-672-9929 Fax: 806-553-1531 | |
Ron K. Rankin, M.d.,p.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 W 14th Ave, Amarillo, TX 79101 Phone: 806-622-2725 Fax: 806-352-4887 | |