Healthcare Provider Details

I. General information

NPI: 1386214872
Provider Name (Legal Business Name): TOTAL ACCESS SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2021
Last Update Date: 09/29/2021
Certification Date: 09/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3809 E 9TH ST STE 15
TEXARKANA AR
71854-5818
US

IV. Provider business mailing address

1420 OWL RDG
TEXARKANA AR
71854-0021
US

V. Phone/Fax

Practice location:
  • Phone: 870-621-0080
  • Fax: 870-621-0081
Mailing address:
  • Phone: 870-621-0080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SAM ALLEN NIX
Title or Position: PRESIDENT/FNP
Credential: FNP
Phone: 870-621-0080