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General NPI Number Information
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NPI Number | 1013631019
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Entity Type | Organization
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Legal Business Name | WEST TEXAS OPTIMAL HEALTH
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Dates
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Enumeration Date | 10/03/2022
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Last Update Date | 11/16/2023
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Provider Practice Location Address
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Address Line | 915 AUSTIN ST
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City | LEVELLAND
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State | TX
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Zip | 79336-4421
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Country | US
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Telephone | 806-310-2715
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Fax |
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Provider Business Mailing Address
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Address Line | 915 AUSTIN ST
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City | LEVELLAND
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State | TX
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Zip | 79336-4421
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Country | US
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Telephone | 806-310-2715
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER/OWNER
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Name | MRS. MICHELLE ACEVEDO
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Credential | FNP
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Telephone | 806-241-1664
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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