Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JACK K WILLIS JR., PA
ActiveJACK K WILLIS JR., PA is a Physician Assistant healthcare provider located in ODESSA, Texas. NPI 1063664183 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · ODESSA, TX
Registration Details
- NPI Number
- 1063664183
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 21, 2008 (17.630816789879 yrs)
- Last Updated
- Dec 12, 2025
- License
-
PA05950 (TX)
Practice Information
- Address
-
4060 MEDICAL PARK DR # AODESSA, TX, 797652233Browse TX providers · Browse ZIP 79765
- Phone
- 4325822882
- Fax
- 4325822884
- Primary Specialty
-
Physician Assistant
363A00000X
Other Physician Assistant Providers in ODESSA, TX
| Name | Credential | NPI |
|---|---|---|
| STEVEN R DILLARD | PAC | 1326089368 |
| TONA SCOTT | PA | 1922035930 |
| TONY D SADLER | PAC | 1851328017 |
| PHILIP A GENTILE | PA | 1528095361 |
| TABATHA J PITTMAN | PA-C | 1942361936 |
| JUANITA C LOPEZ | PA | 1194855817 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.