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General NPI Number Information
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NPI Number | 1043795347
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Entity Type | Individual
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Provider Name | BRIAN RICHARD HONEKAMP AGACNP-BC
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Gender | Male
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Dates
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Enumeration Date | 10/02/2018
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Last Update Date | 08/10/2023
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Provider Practice Location Address
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Address Line | 3506 21ST ST STE 602
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City | LUBBOCK
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State | TX
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Zip | 79410-1234
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Country | US
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Telephone | 67-254-4258
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Fax | 806-723-7347
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Provider Business Mailing Address
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Address Line | 816 W CANNON ST
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City | FORT WORTH
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State | TX
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Zip | 76104-3194
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Country | US
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Telephone | 817-321-0404
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | AP139029
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP139029
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License Number State | TX
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