Jack K Willis JR., PA

NPI #1063664183 in Odessa, Texas

Provider Information

NPI Number: 1063664183
Entity Type: Individual
Name: Jack K Willis JR., PA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Oct 21, 2008
Last Updated: Dec 12, 2025

Practice Location

Address: 4060 MEDICAL PARK DR # A
City: Odessa
State: Texas
ZIP Code: 79765-2233
Phone: (432) 582-2882

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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