Healthcare Provider Details

I. General information

NPI: 1164095782
Provider Name (Legal Business Name): THE MILK SPOT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2021
Last Update Date: 04/02/2024
Certification Date: 03/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 BROOK AVE
WICHITA FALLS TX
76301
US

IV. Provider business mailing address

2001 BROOK AVE
WICHITA FALLS TX
76301
US

V. Phone/Fax

Practice location:
  • Phone: 940-285-5052
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number
License Number State

VIII. Authorized Official

Name: DR. CARI GUIDRY
Title or Position: OWNER
Credential: DC
Phone: 940-285-5052