Healthcare Provider Details

I. General information

NPI: 1356260012
Provider Name (Legal Business Name): TWIN LAKES FAMILY PRACTICE AND MEDICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 SWAN LN
FLIPPIN AR
72634-8795
US

IV. Provider business mailing address

320 SWAN LN
FLIPPIN AR
72634-8795
US

V. Phone/Fax

Practice location:
  • Phone: 870-421-9171
  • Fax:
Mailing address:
  • Phone: 870-421-9171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: LESLI VARGAS
Title or Position: OWNER
Credential: APRN
Phone: 870-421-9171