Provider Demographics
NPI:1326029703
Name:MORGAN, RONALD THANE (MD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:THANE
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 1:1600 S COULTER ST
Mailing Address - Street 2:BUILDING B
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-1710
Mailing Address - Country:US
Mailing Address - Phone:806-355-4900
Mailing Address - Fax:806-355-4903
Practice Address - Street 1:1600 S COULTER ST
Practice Address - Street 2:BUILDING B
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1710
Practice Address - Country:US
Practice Address - Phone:806-355-4900
Practice Address - Fax:806-355-4903
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-10
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1264207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0008ECOtherBCBS TX
TX119873102OtherFIRSTCARE
TXP00329832OtherRAILROAD MEDICARE
TX0312159-04OtherMEDICAID - SUPERIOR HEALTHPLAN - CHIP
TX031215904Medicaid
TXP00329832OtherRAILROAD MEDICARE
TXG96600Medicare UPIN