NPIMap

Organization Active NPI

NWTX Physician Network, PLLC

  • Family Medicine Physician
  • Amarillo, TX
National Provider Identifier
1790109916
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NWTX PHYSICIAN NETWORK, PLLC
Practice address
2505 Lakeview Dr
Suite 205
Amarillo, TX 79109-1527
Phone
(806) 803-9552
NPI assigned
Feb 7, 2014
Last updated
Jun 18, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Authorized official

Name
Mr. Todd Evans
Title
VP
Phone
(610) 768-3300

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU
Physician Assistant 363A00000X NU
Family Medicine Physician 207Q00000X NU Primary
Internal Medicine Physician 207R00000X NU
Orthopaedic Surgery Physician 207X00000X NU
Otolaryngology Physician 207Y00000X NU
Neurology Physician 2084N0400X NU
Psychiatry Physician 2084P0800X NU
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X NU
Hospitalist Physician 208M00000X NU
Hospice and Palliative Medicine (Obstetrics & Gynecology) Physician 207VH0002X NU

Addresses

Primary practice location

2505 Lakeview Dr
Suite 205
Amarillo, TX 79109-1527

Mailing address

PO Box 3046
Malvern, PA 19355-0746

Other identifiers 2

IdentifierTypeStateIssuer
3394710-01MedicaidTX
DU9905OtherTXRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140626000259 TX Part B Supplier - Clinic/Group Practice 4688899149 Receives reassigned benefits from 46 practitioners
Practice locations: Amarillo, TX; Canyon, TX; Borger, TX
O20230425002710 TX Part A Provider - Rural Health Clinic 4688899149 1 other NPI on this enrollment
Practice locations: Borger, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1790109916. Details of each certification follow.

Rural health clinic certification: CCN 678944

Legal name
NWTX PHYSICIAN NETWORK PLLC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Apr 17, 2025
Last certification
Apr 17, 2025
Ownership / control type
1B
Organization structure
LLCProprietary
Incorporated
Jan 15, 2014 in TX
Enrollment address
104 N Bryan St
Borger, TX 79007-4010

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1600 S Coulter St
#F
Amarillo, TX 79106
Phone (806) 398-3627

2001 S Coulter St
Ste 2001
Amarillo, TX 79106
Phone (806) 318-5777

2505 Lakeview Dr
Ste 205
Amarillo, TX 79109
Phone (806) 463-7001

5601 W Interstate 40
Amarillo, TX 79106
Phone (806) 318-5777

5601 W Interstate 40
Ste 100
Amarillo, TX 79106
Phone (806) 414-8022

Ownership & related parties

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Uhs of Fairmount Inc Organization, King of Prussia, PA Corporation 5% Or Greater Indirect Ownership Interest Apr 30, 2014 100%
Steve Filton Individual Corporate OfficerSVP/Cfo Apr 1, 2014
Corporate DirectorSVP/Cfo Apr 1, 2014
Independence Amarillo, LLC Organization, King of Prussia, PA LLC 5% Or Greater Indirect Ownership Interest Apr 30, 2014 100%
Universal Health Services Inc Organization, King of Prussia, PA Corporation 5% Or Greater Indirect Ownership Interest Apr 30, 2014 100%
Independence Physician Management LLC Organization, King of Prussia, PA LLC 5% Or Greater Indirect Ownership Interest Apr 30, 2014 100%
Northwest Texas Physician Group Organization, King of Prussia, PA Corporation 5% Or Greater Direct Ownership Interest Apr 30, 2014 100%
Todd Evans Individual Contracted Managing EmployeeVP Jun 4, 2019 100%
Corporate OfficerVP Jun 4, 2019
Corporate DirectorVP Jun 4, 2019
Alan B Miller Individual 5% Or Greater Indirect Ownership Interest Feb 3, 2014 86.5%
Jeremy Rodriguez Individual Corporate OfficerCoo Oct 1, 2021
Corporate DirectorCoo Oct 1, 2021

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 169

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 169

Practitioners & affiliated clinicians

Practitioners 47

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1391731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750204800000",
    "number": "1790109916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3046",
            "city": "MALVERN",
            "state": "PA",
            "postal_code": "193550746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 LAKEVIEW DR",
            "address_2": "SUITE 205",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791091527",
            "telephone_number": "806-803-9552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NWTX PHYSICIAN NETWORK, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-07",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "610-768-3300",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207VH0002X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Hospice and Palliative Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3394710-01",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DU9905",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

Verify at the official NPI Registry.