# WHITE OAK FAMILY MEDICINE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134787625
- **Authorized official:** KELLY JOHNSON FNP (OWNER/PRACTITIONER)
- **Authorized official phone:** (430) 625-2001

## Contact information

- **Practice address:** 491 E OLD US HIGHWAY 80, WHITE OAK, TX 75693-2106
- **Practice address phone:** (430) 625-2001
- **Practice address fax:** (949) 404-8290
- **Mailing address:** PO BOX 271, WHITE OAK, TX 75693-0271
- **Mailing address phone:** (430) 625-2001

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/30/2019
- **Last updated:** 05/14/2025