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General NPI Number Information
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NPI Number | 1417570003
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Entity Type | Organization
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Legal Business Name | DESIRE TO LIVE NOW, LLC
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Dates
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Enumeration Date | 05/18/2020
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 790 GENERATIONS DR STE 210
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City | NEW BRAUNFELS
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State | TX
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Zip | 78130-0087
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Country | US
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Telephone | 512-643-3631
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Fax | 512-265-9692
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Provider Business Mailing Address
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Address Line | 2115 STEPHENS PL STE 410G
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City | NEW BRAUNFELS
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State | TX
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Zip | 78130-2170
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Country | US
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Telephone | 512-643-3631
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Fax | 512-265-9692
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Authorized Official
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Title or Position | OWNER
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Name | TRACEY SUSANNE MIXON
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Credential | FNP-C
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Telephone | 512-643-3631
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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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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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