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General NPI Number Information
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NPI Number | 1962373803
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Entity Type | Organization
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Legal Business Name | FIREWHEEL TELEMEDICINE, PLLC
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Dates
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Enumeration Date | 09/15/2025
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Last Update Date | 09/17/2026
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Provider Practice Location Address
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Address Line | 4031 112TH ST
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City | LUBBOCK
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State | TX
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Zip | 79423-6749
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Country | US
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Telephone | 817-767-0922
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Fax | 480-588-3093
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Provider Business Mailing Address
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Address Line | 4031 112TH ST
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City | LUBBOCK
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State | TX
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Zip | 79423-6749
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Country | US
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Telephone | 817-767-0922
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Fax | 480-588-3093
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Authorized Official
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Title or Position | OWNER, FOUNDER, PROVIDER
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Name | KATIE BRANDON
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Credential | APRN
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Telephone | 817-767-0922
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084B0002X
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Taxonomy Name | Obesity Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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