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General NPI Number Information
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NPI Number | 1972327203
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Entity Type | Organization
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Legal Business Name | TP NIXA OPS
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Dates
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Enumeration Date | 11/13/2024
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 1919 FITZ LN
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City | NIXA
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State | MO
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Zip | 65714-8459
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Country | US
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Telephone | 409-683-2457
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Fax |
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Provider Business Mailing Address
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Address Line | 1601 ELM ST STE 4210
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City | DALLAS
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State | TX
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Zip | 75201-7282
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Country | US
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Telephone | 469-607-8448
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Fax |
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Authorized Official
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Title or Position | VP COMPLIANCE & HR
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Name | ROBERT BRACE
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Credential |
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Telephone | 469-607-8448
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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