Registry record
- NPI
- 1063664183
- Profession
- Physician Assistant (PA)
- Specialty
- Physician Assistant (363A00000X)
- Practice address
- 4060 Medical Park Dr # A
Odessa, TX 79765 - Phone
- 4325822882
- In the registry since
- October 21, 2008
- Last NPPES update
- December 12, 2025
- Sole proprietor
- No
- License
- PA05950 (TX)
At this location
This location lists no other NP or PA providers in our current data.
In context
The NPI number of Jack Willis is 1063664183. They are a Physician Assistant in Odessa, Texas.
Jack Willis is one of 53 Physician Assistants in Odessa and one of 11,405 across Texas in our data.
The NPI has been in the federal registry for 17 years, since October 21, 2008.
Frequently asked questions
What is NPI 1063664183?
NPI 1063664183 is the 10-digit National Provider Identifier assigned to Jack Willis, a Physician Assistant practicing in Odessa, Texas. The record has been in the NPPES registry since October 21, 2008.
How do I verify this provider?
Cross-check NPI 1063664183 in the official CMS registry at npiregistry.cms.hhs.gov, and confirm license PA05950 with the TX licensing board. You can also run the number through our free NPI validator to confirm its checksum.
Is this information current?
This profile reflects the June 2026 NPPES data file. NPPES lists the record's last update as December 12, 2025. We refresh our data each month when CMS publishes a new file.
Data: NPPES public registry, June 2026 file. Not medical advice. Verify independently before care or credentialing decisions. Errors in the source record can be corrected at nppes.cms.hhs.gov; see our corrections page.