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Organization
NSMD MEDICAL PLLC
Active
Organization
NSMD MEDICAL PLLC
Active
Other names
VITAL CARE FAMILY PRACTICE
Organization subpart
No
Provider details
NPI number
Authorized official
CANDACE D WYNNE (BILLING)
(432) 704-5663
Entity
Organization
Contact information
Practice address
4400 N MIDLAND DR, 406B, MIDLAND, TX 79707-3385
(432) 704-5663
(432) 704-5660
Mailing address
PO BOX 4467, MIDLAND, TX 79704-4467
(432) 704-5663
(432) 704-5660
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
AP121037
TX
207Q00000X
Family Medicine Physician
AP128857
TX
207Q00000X
Family Medicine Physician
Primary
Q7356
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1144696436
NPI
TX
01
—
1417224403
NPI
TX
01
—
1811334105
NPI
TX
Enumeration date
01/09/2017
Last updated
01/09/2017
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