Provider Demographics
NPI:1316049042
Name:WARNICA, JAMES MILTON (PSYD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MILTON
Last Name:WARNICA
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 50548
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79159-0548
Mailing Address - Country:US
Mailing Address - Phone:806-353-4372
Mailing Address - Fax:806-353-4373
Practice Address - Street 1:3611 S SONCY RD
Practice Address - Street 2:SUITE 7-A
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79119-6480
Practice Address - Country:US
Practice Address - Phone:806-353-4372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23391103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0979429-02Medicaid
TX187244OtherVALUE OPTIONS
TX0979429-02Medicaid