NPIMap

Organization Active NPI

Texas Tech University Health Sciences Center at Amarillo

  • Diagnostic Radiology Physician
  • Amarillo, TX
National Provider Identifier
1710030366
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
R05258 Issued in TX
Legal business name
TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER AT AMARILLO
Practice address
1400 S Coulter St
Amarillo, TX 79106-1786
Phone
(806) 354-5700
NPI assigned
Jan 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Denise Russell, CPCS
Title
Credentialing Coordinator
Phone
(806) 354-5495

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085B0100X R05258 TX
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X R05258 TX Primary

Addresses

Primary practice location

1400 S Coulter St
Amarillo, TX 79106-1786

Mailing address

1400 Wallace Blvd
Amarillo, TX 79106-1708
Phone (806) 354-5700

Other identifiers 1

IdentifierTypeStateIssuer
R05258OtherTXCERTIFICATE OF X-RAY REGI

Other names 1

  • Radiology Lab Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Texas Tech University Health Sciences Center9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1710030366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 WALLACE BLVD",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061708",
            "telephone_number": "806-354-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S COULTER ST",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061786",
            "telephone_number": "806-354-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER AT AMARILLO",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "806-354-5495",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CPCS"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Body Imaging",
            "state": "TX",
            "license": "R05258",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "R05258",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFICATE OF X-RAY REGI",
            "identifier": "R05258",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Radiology Lab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Amarillo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.