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General NPI Number Information
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NPI Number | 1568529477
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Entity Type | Organization
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Legal Business Name | FOUNDATIONS OF TEXOMA ENTERPRISES, PA
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 1801 9TH ST
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City | WICHITA FALLS
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State | TX
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Zip | 76301-5029
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Country | US
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Telephone | 940-247-4751
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Fax | 940-247-4755
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Provider Business Mailing Address
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Address Line | 1411 9TH ST
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City | WICHITA FALLS
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State | TX
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Zip | 76301-4302
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Country | US
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Telephone | 940-322-6981
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Fax | 940-322-1907
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL ALAN ANDERSON
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Credential | MD
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Telephone | 940-247-4751
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | L5975
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License Number State | TX
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