# WEST TEXAS A&M UNIVERSITY STUDENT MEDICAL SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Student Medical Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407967599
- **Authorized official:** LUANNE RICKWARTZ R.N. (DIRECTOR)
- **Authorized official phone:** (806) 651-3287

## Contact information

- **Practice address:** 2620 N RUSSEL LONG BLVD, VIRGIL HENSON ACTIVITIES CENTER ROOM 104, CANYON, TX 79016-0001
- **Practice address phone:** (806) 651-3287
- **Practice address fax:** (806) 651-3289
- **Mailing address:** WTAMU PO BOX 61401, WEST TEXAS A&M UNIVERSITY STUDENT MEDICAL SERVICES, CANYON, TX 79016-0001
- **Mailing address phone:** (806) 651-3287
- **Mailing address fax:** (806) 651-3289

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QS1000X | Student Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/31/2006
- **Last updated:** 11/19/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 91914669 | TPI | TX |