KETAMINE CLINIC OF WEST TEXAS (NPI# 1740808070) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1740808070 |
Entity Type | Organization |
Organization Name | KETAMINE CLINIC OF WEST TEXAS |
Practice Address |
5105 Sunmore Cir Ste A Midland TX 79707-5197 |
Practice Telephone | 4323522865 |
Practice Fax Number | 4326956411 |
Mailing Telephone | 4323522865 |
Mailing Fax Number | 4326956411 |
Enumeration Date | 2020-07-13 |
Last Update Date | 2020-07-13 |
Authorized Official Name | TAMARA LYNN VAUGHT (OWNER) |
Authorized Official Telephone | 4323522865 |
Authorized Official Credential | CRNA |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
Street Address |
5105 SUNMORE CIR STE A |
City | MIDLAND |
State | TX |
Zip Code | 79707-5197 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548861164 | Daniel & Max, LLC | Optometrist | 3110 N Loop 250 W, Suite 200, Midland, TX 79707 | 2020-11-02 |
1396196036 | Endurance Inc | Pharmacy | 4906 Briarwood, Midland, TX 79707 | 2016-06-23 |
1841683356 | Carson Riley Phillips | Dentist | 4425 W Wadley Ave Ste 100, Midland, TX 79707 | 2015-03-07 |
1336538610 | Permian Basin Er II | Clinic/Center | 3201 N. Midland Drive, Ste 130, Midland, TX 79707 | 2015-01-09 |
1659776342 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 5315 Briarwood Ave, Midland, TX 79707 | 2014-10-24 |
1982958799 | Tara Rae Nagel | Nurse Practitioner | 4214 Mamies Cir, Midland Pediatric Associates, Midland, TX 79707 | 2012-10-31 |
1336432046 | Ashley Thrasher Bell | Physician Assistant | 3600 N Garfield, Ttuhsc Pa Program, Midland, TX 79707 | 2011-05-27 |
1053626622 | Jerry Milton Lyon | Nurse Practitioner | 5000 Briarwood Ave Ste 203, Midland, TX 79707 | 2010-08-08 |
1053645838 | Marta Willoughby Md Pa | Clinic/Center | 3423 Caldera, Midland, TX 79707 | 2009-09-25 |
1326251950 | Bonnie Lloyd Clemmer | Registered Nurse | 3600 W Loop 250 North, Apt 1083, Midland, TX 79707 | 2007-05-08 |
Find all providers in zip 79707 |
Taxonomy Code | 261Q00000X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013169044 | Mcandrew's Eye Clinic | Clinic/Center | 700 N Marienfeld St, Midland, TX 79701-3360 | 2008-10-22 |
1477560068 | Permian Basin Community Centers for Mhmr | Clinic/Center | 401 E Illinois Ave, Ste 400, Midland, TX 79701 | 2006-08-03 |
1487669875 | Permian Basin Community Centers for Mhmr | Clinic/Center | 3701 N Big Spring, Midland, TX 79702 | 2006-07-31 |
1497700884 | First K. Craig Keate Dds Ltd | Clinic/Center | 4610 N Garfield St, #b-12, Midland, TX 79705-2663 | 2006-05-23 |
1528033032 | Neuro Rehab & Lyphmoedema Care Center | Clinic/Center | 2611 Sunburst Dr, Midland, TX 79707-5111 | 2006-02-18 |
1376973149 | Midmichigan Medical Center Midland | Clinic/Center | 4009 Orchard Dr, Midland, MI 48640-6122 | 2013-11-15 |
1952564650 | Patrick Leung Md Pa | Clinic/Center | 2102 W Michigan Ave, Midland, TX 79701-5928 | 2008-07-03 |
1467463174 | Permain Basin Community Centers for Mhmr | Clinic/Center | 401 E Illinois Ave, Ste 400, Midland, TX 79701-4803 | 2006-08-10 |
1801806021 | Permian Basin Community Centers for Mhmr | Clinic/Center | 401 E Illinois Ave, Ste 200, Midland, TX 79701 | 2006-08-09 |
1306855465 | Permian Basin Community Centers for Mhmr | Clinic/Center | 401 E Illinois Ave, Ste 200, Midland, TX 79701 | 2006-08-07 |
Find all providers in MIDLAND |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.