| Ketamine Clinic Of West Texas | |
|
5105 Sunmore Cir Ste A Midland TX 79707-5197 | |
| (432) 352-2865 | |
| (432) 695-6411 |
| Full Name | Ketamine Clinic Of West Texas |
|---|---|
| Speciality | Clinic/center |
| Location | 5105 Sunmore Cir Ste A, Midland, Texas |
| Authorized Official Name and Position | Tamara Lynn Vaught (OWNER) |
| Authorized Official Contact | 4323522865 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ketamine Clinic Of West Texas 5105 Sunmore Cir Ste A Midland TX 79707-5197 Ph: (432) 352-2865 | Ketamine Clinic Of West Texas 5105 Sunmore Cir Ste A Midland TX 79707-5197 Ph: (432) 352-2865 |
| NPI Number | 1740808070 |
|---|---|
| Provider Enumeration Date | 07/13/2020 |
| Last Update Date | 07/13/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740808070 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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