Provider Demographics
NPI:1609909944
Name:AMARILLO GASTROENTEROLOGY ASSOCIATES
Entity Type:Organization
Organization Name:AMARILLO GASTROENTEROLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MALWINDER
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:SIDHU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-365-2754
Mailing Address - Street 1:PO BOX 51508
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79159-1508
Mailing Address - Country:US
Mailing Address - Phone:806-356-2754
Mailing Address - Fax:806-356-2820
Practice Address - Street 1:1901 MEDI PARK DR
Practice Address - Street 2:SUITE 1030
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-2110
Practice Address - Country:US
Practice Address - Phone:806-356-2754
Practice Address - Fax:806-356-2820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8130207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0036AHMedicare ID - Type Unspecified