Organization
KELL WEST FAMILY PRACTICE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTA ZIMPEL (ADMINISTRATOR)
(940) 689-2319
Entity
Organization
Contact information
Practice address
4412 KELL BLVD, WICHITA FALLS, TX 76309-4719
(940) 696-0011
Mailing address
4412 KELL BLVD, WICHITA FALLS, TX 76309-4719
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
156193801
—
TX
01
—
CK5579
RAILROAD MEDICARE
—
Enumeration date
07/19/2014
Last updated
07/19/2014
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