EVERGREEN TESTOSTERONE CLINIC & PRIMARY CARE NPI 1942710256

NPI Information

  • NPI: 1942710256
  • Provider Name: EVERGREEN TESTOSTERONE CLINIC & PRIMARY CARE
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • CLIA Number: 45D2139078
  • Address: 623 MATLOCK CENTRE CIR
    ARLINGTON, TX
    ZIP 76015
  • Phone: (214) 870-0885

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NPI Details

EVERGREEN TESTOSTERONE CLINIC & PRIMARY CARE is a primary care clinic center in Arlington, TX. EVERGREEN TESTOSTERONE CLINIC & PRIMARY CARE NPI is 1942710256. The provider is registered as an organization entity type.

The provider's business location address is:

623 MATLOCK CENTRE CIR
ARLINGTON, TX
ZIP 76015-535
Phone: (214) 870-0885

The provider's authorized official is Ken Wamwiri .
The authorized official title is President And Ceo and has the following contact phone number (214) 870-0885.

The CLIA number assigned to this NPI record is 45D2139078 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/2/2017 and was last updated on 7/14/2025.

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
1261QP2300XClinic/CenterPrimary CareYes

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: 11/21/2025

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