# KETAMINE HEALTH & WELLNESS CENTER OF TEXAS

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

## Provider details

- **NPI number:** 1295257988
- **Authorized official:** MRS. LESLIE K HILL (BILLING MANAGER)
- **Authorized official phone:** (972) 980-0500

## Contact information

- **Practice address:** 5944 W PARKER RD STE 400, PLANO, TX 75093-6443
- **Practice address phone:** (972) 980-0500
- **Practice address fax:** (972) 980-0503
- **Mailing address:** 5944 W PARKER RD STE 400, PLANO, TX 75093-6443
- **Mailing address phone:** (972) 980-0500
- **Mailing address fax:** (972) 980-0503

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | L4969 | TX | Yes |

## Other

- **Enumeration date:** 07/13/2017
- **Last updated:** 07/21/2022