Provider Demographics
NPI:1649687344
Name:AMARILLO FOOT SPECIALISTS, PLLC
Entity type:Organization
Organization Name:AMARILLO FOOT SPECIALISTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PODIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:K
Authorized Official - Last Name:HOLLOWAY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:806-322-3338
Mailing Address - Street 1:5109 LEXINGTON SQ STE 200
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79119-6516
Mailing Address - Country:US
Mailing Address - Phone:806-322-3338
Mailing Address - Fax:806-322-7653
Practice Address - Street 1:5109 LEXINGTON SQ STE 200
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79119-6516
Practice Address - Country:US
Practice Address - Phone:806-322-3338
Practice Address - Fax:806-322-7653
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-15
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2113213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty