KELL WEST FAMILY PRACTICE CLINIC NPI 1073565685

NPI Information

NPI: 1073565685
Provider Name: KELL WEST FAMILY PRACTICE CLINIC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 45D0957788

Address:
5500 KELL WEST BLVD
SUITE 400
WICHITA FALLS, TX
ZIP 76310
Phone: (940) 696-0011
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KELL WEST FAMILY PRACTICE CLINIC is a primary care clinic center in Wichita Falls, TX. KELL WEST FAMILY PRACTICE CLINIC NPI is 1073565685. The provider is registered as an organization entity type.

The provider's business location address is:

5500 KELL WEST BLVD
SUITE 400
WICHITA FALLS, TX
ZIP 76310-612
Phone: (940) 696-0011
Fax: (940) 696-2248

The provider's authorized official is Micheal Allan Moisant .
The authorized official title is General Partner and has the following contact phone number (940) 696-0011.

The CLIA number assigned to this NPI record is 45D0957788 - hospital with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 5/16/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0078HQ	OTHER	TEXAS	BCBS OF TEXAS
2	CK5579	OTHER	TEXAS	RAILROAD MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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