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General NPI Number Information
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NPI Number | 1831050723
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Entity Type | Organization
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Legal Business Name | MOSAIC PSYCHIATRIC SERVICES PLLC
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Dates
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Enumeration Date | 11/20/2025
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Last Update Date | 11/20/2025
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Provider Practice Location Address
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Address Line | 807 8TH ST STE 1108
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City | WICHITA FALLS
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State | TX
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Zip | 76301-3309
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Country | US
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Telephone | 940-340-3061
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Fax | 940-301-3920
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Provider Business Mailing Address
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Address Line | 807 8TH ST STE 1108
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City | WICHITA FALLS
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State | TX
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Zip | 76301-3309
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Country | US
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Telephone | 940-340-3061
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Fax | 940-301-3920
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Authorized Official
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Title or Position | PMHNP
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Name | KELLYE MIXSON
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Credential | MSN, APRN, PMHNP
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Telephone | 940-340-3061
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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