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General NPI Number Information
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NPI Number | 1467326561
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Entity Type | Organization
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Legal Business Name | MUSTARD SEED CENTER, LLC
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Dates
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Enumeration Date | 10/01/2025
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 1201 HEWITT DR STE 107
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City | WACO
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State | TX
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Zip | 76712-8834
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Country | US
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Telephone | 254-572-8890
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Fax | 254-231-3754
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Provider Business Mailing Address
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Address Line | 1201 HEWITT DR STE 107
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City | WACO
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State | TX
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Zip | 76712-8834
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Country | US
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Telephone | 254-572-8890
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Fax | 254-231-3754
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Authorized Official
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Title or Position | OWNER
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Name | CASIE WARD
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Credential |
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Telephone | 254-572-8890
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0006X
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Taxonomy Name | Developmental - Behavioral Pediatrics Physician
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License Number |
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License Number State |
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