Organization
KETAMINE CLINIC OF WEST TEXAS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMARA LYNN VAUGHT CRNA (OWNER)
(432) 352-2865
Entity
Organization
Contact information
Practice address
5105 SUNMORE CIR STE A, MIDLAND, TX 79707-5197
(432) 352-2865
(432) 695-6411
Mailing address
5105 SUNMORE CIR STE A, MIDLAND, TX 79707-5197
(432) 352-2865
(432) 695-6411
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
07/13/2020
Last updated
07/13/2020
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