Provider Demographics
NPI:1275118580
Name:AND MEDICAL SERIES
Entity Type:Organization
Organization Name:AND MEDICAL SERIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:AUZENNE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:806-681-5629
Mailing Address - Street 1:7460 GOLDEN POND PL STE 300
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79121-1958
Mailing Address - Country:US
Mailing Address - Phone:806-681-5629
Mailing Address - Fax:
Practice Address - Street 1:7460 GOLDEN POND PL STE 400
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79121-1959
Practice Address - Country:US
Practice Address - Phone:806-681-5629
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOSHUA AUZENNE, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-03-17
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty