Willis, Jack K
Willis, Jack K is an individual health care provider with primary practice located at 4060 Medical Park Dr # A , Odessa TX 79765-2233. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Willis, Jack K can be contacted via phone (432) 582-2882.Contact Information
Primary practice address
4060 Medical Park Dr # A
Odessa TX 79765-2233
Phone: (432) 582-2882
Fax: (432) 582-2884
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA05950 | Texas |
Profile Details
| NPI number | 1063664183 |
|---|---|
| LBN Legal business name | Willis, Jack K |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 21st, 2008 |
| Last updated | Dec 12th, 2025 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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