Provider Demographics
NPI:1740373976
Name:AMARILLO UROLOGY ASSOCIATES LLP
Entity type:Organization
Organization Name:AMARILLO UROLOGY ASSOCIATES LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:WHITT
Authorized Official - Last Name:HOLDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-350-4100
Mailing Address - Street 1:1900 MEDI PARK DR
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-2104
Mailing Address - Country:US
Mailing Address - Phone:806-355-9447
Mailing Address - Fax:806-356-9251
Practice Address - Street 1:1900 MEDI PARK DR
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-2104
Practice Address - Country:US
Practice Address - Phone:806-355-9447
Practice Address - Fax:806-356-9251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00R54ZMedicare ID - Type UnspecifiedMEDICARE ID