Provider Demographics
NPI:1942215488
Name:PANHANDLE OBSTETRICS & GYNECOLOGY
Entity Type:Organization
Organization Name:PANHANDLE OBSTETRICS & GYNECOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:A
Authorized Official - Last Name:MAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-359-5468
Mailing Address - Street 1:7620 WALLACE BLVD
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79124-2154
Mailing Address - Country:US
Mailing Address - Phone:806-359-5468
Mailing Address - Fax:806-358-1162
Practice Address - Street 1:7620 WALLACE BLVD
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79124-2154
Practice Address - Country:US
Practice Address - Phone:806-359-5468
Practice Address - Fax:806-358-1162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX158317102Medicaid
TX00131VMedicare ID - Type Unspecified