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General NPI Number Information
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NPI Number | 1558466276
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Entity Type | Organization
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Legal Business Name | NEWKIRK FAMILY PRACTICE CLINIC LLC
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 4725 GUS THOMASSON RD SUITE 4
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City | MESQUITE
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State | TX
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Zip | 75150-1734
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Country | US
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Telephone | 972-279-6767
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Fax | 972-279-3914
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Provider Business Mailing Address
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Address Line | 4725 GUS THOMASSON RD SUITE 4
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City | MESQUITE
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State | TX
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Zip | 75150-1734
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Country | US
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Telephone | 972-279-6767
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Fax | 972-279-3914
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Authorized Official
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Title or Position | OWNER
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Name | TRIXIE DIANE NEWKIRK
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Credential | FNP-C
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Telephone | 972-279-6767
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | G4442
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License Number State | TX
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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 | 542807
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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 | I16636
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License Number State | TX
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