Organization Name: | PAMPA MEDICAL GROUP |
NPI Number: | 1023495819 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JENIFER RICHARDS (MANAGER) |
Mailing Address: | 3023 Perryton Pkwy Suite 101 Pampa |
State: | TX US |
Postal Code: | 790652821 |
Phone Number: | 8066650801 |
Fax Number: | 8066658503 |
NPI Enumeration Date: | 04/30/2015 |
NPI Last Update Date: | 04/30/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QU0200X |
License Number: | AP128041 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Urgent Care |
Taxonomy Definition: |