Provider Demographics
NPI:1760949200
Name:JOY MEDICAL CLINIC PLLC
Entity Type:Organization
Organization Name:JOY MEDICAL CLINIC PLLC
Other - Org Name:FAITH MEDICAL CLINIC, PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FNP
Authorized Official - Prefix:
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:806-418-2191
Mailing Address - Street 1:4310 S WESTERN ST UNIT E
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-6036
Mailing Address - Country:US
Mailing Address - Phone:806-418-2191
Mailing Address - Fax:806-418-6233
Practice Address - Street 1:4310 S WESTERN ST UNIT E
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-6036
Practice Address - Country:US
Practice Address - Phone:806-418-2191
Practice Address - Fax:806-418-6233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-20
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty