Exceptional Physicians Group Amarillo North PLLC

Key facts

NPI

1336797992

Entity type

Organization (NPI type 2)

Primary specialty

Emergency Medicine Physician 207P00000X

Legal business name

EXCEPTIONAL PHYSICIANS GROUP AMARILLO NORTH PLLC

Practice address

2101 S Coulter St
Amarillo, TX 79106-2513

Phone

(817) 755-7502

Fax

(346) 215-1007

NPI assigned

Aug 27, 2019

Organization subpart

No

Authorized official

Name

Saeed S Mahboubi

Title

Cfo

Phone

(214) 533-0034

National Provider Directory

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 27, 2019.

{
    "created_epoch": "1566864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566864000000",
    "number": "1336797992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 S COULTER ST",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791062513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 S COULTER ST",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791062513",
            "telephone_number": "817-755-7502",
            "fax_number": "346-215-1007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCEPTIONAL PHYSICIANS GROUP AMARILLO NORTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-27",
        "last_updated": "2019-08-27",
        "status": "A",
        "authorized_official_last_name": "MAHBOUBI",
        "authorized_official_first_name": "SAEED",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "214-533-0034"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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