Provider Demographics
NPI:1235433780
Name:MCBROOM, ANGELA T (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:T
Last Name:MCBROOM
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-1531
Mailing Address - Country:US
Mailing Address - Phone:806-355-8900
Mailing Address - Fax:806-355-2453
Practice Address - Street 1:7306 SW 34TH AVE STE 3
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79121-1446
Practice Address - Country:US
Practice Address - Phone:806-350-3010
Practice Address - Fax:806-350-3015
Is Sole Proprietor?:No
Enumeration Date:2010-12-26
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant