NORTHWEST TEXAS WYATT CLINIC PLLC (NPI# 1780008904) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780008904 |
| Entity Type | Organization |
| Organization Name | NORTHWEST TEXAS WYATT CLINIC PLLC |
| Practice Address |
1411 E Amarillo Blvd Amarillo TX 79107-5555 |
| Mailing Address |
367 S Gulph Rd King of Prussia PA 19406-3121 |
| Practice Telephone | 8063541015 |
| Enumeration Date | 2014-02-07 |
| Last Update Date | 2019-06-27 |
| Authorized Official Name | TODD EVANS (VP) |
| Authorized Official Telephone | 6107683300 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 208D00000X | General Practice | Allopathic & Osteopathic Physicians | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 3393704 01 | 05 | |
| TX | RR MEDICARE | DV2201 | 01 |
| Street Address |
1411 E AMARILLO BLVD |
| City | AMARILLO |
| State | TX |
| Zip Code | 79107-5555 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396726212 | Jeffrey S Pickens | Family Medicine | 1411 E Amarillo Blvd, Amarillo, TX 79107-5555 | 2005-11-08 |
| 1760030100 | Jennifer Kathryn Ebeling | Nurse Practitioner | 1411 E Amarillo Blvd, Amarillo, TX 79107-5555 | 2019-08-29 |
| 1073175154 | Todd M Walls | Pharmacist | 1411 E Amarillo Blvd, Amarillo, TX 79107-5555 | 2019-06-28 |
| 1245796911 | William Bowman | Nurse Practitioner | 1411 E Amarillo Blvd, Amarillo, TX 79107-5555 | 2019-02-18 |
| 1427523737 | Meredith Mercer | Pharmacist | 1411 E Amarillo Blvd, Amarillo, TX 79107-5555 | 2018-10-12 |
| 1043766272 | Blanca Rangel | Nurse Practitioner | 1411 E Amarillo Blvd, Amarillo, TX 79107-5555 | 2016-08-28 |
| 1063863314 | Brandi Lehning | Nurse Practitioner | 1411 E Amarillo Blvd, Amarillo, TX 79107-5555 | 2016-06-28 |
| 1770903304 | Whitney L Dowd | Nurse Practitioner | 1411 E Amarillo Blvd, Amarillo, TX 79107-5555 | 2014-04-22 |
| 1578998951 | Cecelia Garcia Brewer | Nurse Practitioner | 1411 E Amarillo Blvd, Amarillo, TX 79107-5555 | 2013-09-04 |
| 1215371539 | Alanna Briane Barfoot | Family Medicine | 1411 E Amarillo Blvd, Amarillo, TX 79107-5555 | 2013-04-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851738884 | Daniel J Meadors | Dentist | 2201 N. Grand, Amarillo, TX 79107 | 2013-05-31 |
| 1568660785 | Keelie Nicole Hauk | Dental Hygienist | 850 Martin Road, Amarillo, TX 79107 | 2007-07-10 |
| 1346361664 | Daniel J Meadors Dds Inc | Dentist | 2201 N Grand, Amarillo, TX 79107 | 2007-04-03 |
| 1881701795 | John C Curry | Dentist | 2201 N Grand St, Amarillo, TX 79107 | 2006-08-24 |
| 1285633305 | Kathy Ann Ford | Nurse Practitioner | 824 Martin Rd, Amarillo, TX 79107 | 2005-07-20 |
| 1629572854 | Ihnbae Cho | Dentist | 206 Ne 7th Ave, Amarillo, TX 79107 | 2018-03-21 |
| 1467736363 | Maria Fernanda Contreras | Pediatrics | 713 N Taylor St, Amarillo, TX 79107 | 2011-10-11 |
| 1477735322 | Timothy John Revell | Emergency Medicine | 9601 Spur 591, Amarillo, TX 79107 | 2007-12-03 |
| 1851309280 | John Michael Archer | Dentist | 1900 Coulter Road, Suite G, Amarillo, TX 79107-1732 | 2006-08-03 |
| 1386067593 | Amber Leigh Roth | Nurse Practitioner | 1411 East Amarillo Blvd, Amarillo, TX 79107-1770 | 2014-01-23 |
| Find all providers in zip 79107 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720630825 | Yalamanchili Physicians Group Pllc | Internal Medicine | 62 Prestwick Ln, Amarillo, TX 79124-4975 | 2019-07-10 |
| 1861924623 | Ryan Batson Smithee | Internal Medicine | 1301 S Coulter St Ste 107, Amarillo, TX 79106-1764 | 2017-03-31 |
| 1972967529 | David Wayne Hohon | Internal Medicine | Bsa Physician Group, 1600 Wallace Blvd., Amarillo, TX 79106 | 2016-04-11 |
| 1881074524 | Susan Mbu | Internal Medicine | 1501 Coulter Road, Amarillo, TX 79106 | 2015-06-08 |
| 1043698681 | Msj Services Pllc | Internal Medicine | 26 Medical Dr Ste A, Amarillo, TX 79106-4129 | 2015-05-15 |
| 1467874537 | Susan Elizabeth Ellington | Internal Medicine | 7659 Hillside Rd, Suite 300, Amarillo, TX 79119 | 2014-01-09 |
| 1497189526 | Saeed Md Pllc | Internal Medicine | 3144 W 28th Ave, Suite C, Amarillo, TX 79109-3169 | 2013-08-26 |
| 1922399724 | Reesha Mahnoor | Internal Medicine | 1400 Coulter Street, Ttuhsc, Amarillo, TX 79106-1708 | 2011-04-27 |
| 1457652075 | Charles W. Seward | Internal Medicine | 237 Lisa Ln, Amarillo, TX 79118-8021 | 2010-11-12 |
| 1366754673 | Lylla Ngo | Internal Medicine | 1400 S Coulter St Ste 2500, Amarillo, TX 79106-1786 | 2010-07-02 |
| Find all providers in AMARILLO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.