Provider Demographics
NPI:1235210121
Name:MORGAN, DARRELL I (MD)
Entity Type:Individual
Prefix:
First Name:DARRELL
Middle Name:I
Last Name:MORGAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3440 BELL,
Mailing Address - Street 2:SUITE 320, #186
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109
Mailing Address - Country:US
Mailing Address - Phone:806-322-3230
Mailing Address - Fax:
Practice Address - Street 1:3440 BELL ST
Practice Address - Street 2:SUITE 320, #186
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-4142
Practice Address - Country:US
Practice Address - Phone:806-322-3230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2014-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG9038207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX139019707Medicaid
OK100222110AMedicaid
TX85365BOtherBLUE CROSS & BLUE SHIELD
NM64334597Medicaid
OK100222110AMedicaid
TX85365BMedicare PIN
TX139019707Medicaid