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Organization
VAN FAMILY MEDICAL
Active
Organization
VAN FAMILY MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORETTA WILSON FNP (OWNER)
(903) 515-0690
Entity
Organization
Contact information
Practice address
488 W MAIN ST, STE 101, VAN, TX 75790-2608
(903) 963-6850
Mailing address
488 W MAIN ST, STE 101, VAN, TX 75790-2608
(903) 963-6850
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/08/2021
Last updated
06/28/2022
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