Organization
INSTACLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY R SURDAM FNP (COO)
(307) 421-7277
Entity
Organization
Contact information
Practice address
7008 QUARTERMILE LN, DALLAS, TX 75248-1448
(307) 256-8556
Mailing address
PO BOX 1142, CHEYENNE, WY 82003-1142
(307) 421-7277
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1659978401
NPI
—
Enumeration date
10/05/2020
Last updated
12/21/2022
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