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5701 Time Square Blvd Ste 220 Amarillo TX 79119-1178 | |
(806) 350-7311 | |
(806) 350-7361 |
Full Name | |
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Speciality | Internal Medicine |
Location | 5701 Time Square Blvd Ste 220, Amarillo, Texas |
Authorized Official Name and Position | Kathleen Anne Clark (MD) |
Authorized Official Contact | 8063507311 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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5701 Time Square Blvd Ste 220 Amarillo TX 79119-1178 Ph: (806) 350-7311 | 5701 Time Square Blvd Ste 220 Amarillo TX 79119-1178 Ph: (806) 350-7311 |
NPI Number | 1083085385 |
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Provider Enumeration Date | 10/13/2015 |
Last Update Date | 11/09/2017 |
Medicare PECOS PAC ID | 1355609736 |
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Medicare Enrollment ID | O20171212000986 |
Identifier | Type | State | Issuer |
---|---|---|---|
1083085385 | NPI | - | NPPES |
1083085385 | Other | TX | NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | P8871 (Texas) | Primary |
Provider Name | Kathleen A Clark |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1518103886 PECOS PAC ID: 5294890414 Enrollment ID: I20090223000077 |
Provider Name | Christi Ann Rogers |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1073091914 PECOS PAC ID: 5395084891 Enrollment ID: I20190227002788 |
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 | |