Provider Demographics
NPI:1982652202
Name:AMARILLO PATHOLOGY GROUP CLINICAL LLP
Entity Type:Organization
Organization Name:AMARILLO PATHOLOGY GROUP CLINICAL LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:WALTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-355-7286
Mailing Address - Street 1:PO BOX 50117
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79159-0117
Mailing Address - Country:US
Mailing Address - Phone:806-355-7286
Mailing Address - Fax:
Practice Address - Street 1:3501 S SONCY RD
Practice Address - Street 2:SUITE 116
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79119-6407
Practice Address - Country:US
Practice Address - Phone:806-355-7286
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0086CCOtherBCTX