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Organization

D ESTHETIQUE COSMETIC &LASER CENTER

Active
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Organization

D ESTHETIQUE COSMETIC &LASER CENTER

Active
Other names
D Esthetique Medical Aesthetics & Wellness Center
Organization subpart
No

Provider details

NPI number
Authorized official
REGINA MARIE HOWARD FAMILY NURSE PRACTIT (BUSINESS OWNER/NURSE PRACTITIONER)
(940) 692-1706
Entity
Organization

Contact information

Practice address
3916 CALLFIELD ROAD, SUITE 300, WICHITA FALLS, TX 76308
(940) 692-1706
(940) 687-1794
Mailing address
3916 CALLFIELD ROAD, SUITE 300, WICHITA FALLS, TX 76308
(940) 692-1706
(940) 687-1794

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1568414753
NPI NUMBER
TX
Enumeration date
11/25/2019
Last updated
02/05/2020
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