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General NPI Number Information
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NPI Number | 1528504065
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Entity Type | Organization
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Legal Business Name | NSMD MEDICAL PLLC
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Dates
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Enumeration Date | 01/09/2017
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Last Update Date | 01/09/2017
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Provider Practice Location Address
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Address Line | 4400 N MIDLAND DR 406B
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City | MIDLAND
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State | TX
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Zip | 79707-3385
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Country | US
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Telephone | 432-704-5663
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Fax | 432-704-5660
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Provider Business Mailing Address
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Address Line | PO BOX 4467
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City | MIDLAND
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State | TX
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Zip | 79704-4467
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Country | US
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Telephone | 432-704-5663
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Fax | 432-704-5660
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Authorized Official
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Title or Position | BILLING
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Name | CANDACE D WYNNE
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Credential |
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Telephone | 432-704-5663
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | AP121037
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | AP128857
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | Q7356
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License Number State | TX
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