Provider Demographics
NPI:1811172422
Name:AMMAR JARROUS MD PA
Entity type:Organization
Organization Name:AMMAR JARROUS MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BUFFIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-355-3022
Mailing Address - Street 1:3300 COULTER
Mailing Address - Street 2:STE 3 BOX 310
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106
Mailing Address - Country:US
Mailing Address - Phone:806-355-3022
Mailing Address - Fax:806-355-2998
Practice Address - Street 1:6810 PLUM CREEK
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79124
Practice Address - Country:US
Practice Address - Phone:806-355-3022
Practice Address - Fax:806-355-2998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-02
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
208G00000X
TXL2953208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0088KLOtherBLUE CROOS BLUE SHIELD
TX0088KLOtherBLUE CROOS BLUE SHIELD