Provider Demographics
NPI:1871784652
Name:AMARILLO BONE & JOINT CLINIC, PLLC
Entity type:Organization
Organization Name:AMARILLO BONE & JOINT CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-468-9700
Mailing Address - Street 1:1100 S COULTER ST
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-1836
Mailing Address - Country:US
Mailing Address - Phone:806-468-9700
Mailing Address - Fax:806-468-9771
Practice Address - Street 1:1100 S COULTER ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1836
Practice Address - Country:US
Practice Address - Phone:806-468-9700
Practice Address - Fax:806-468-9771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-06
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207QS0010X, 207X00000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6588300001Medicare NSC