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NPI Code Detail

MEDICARE: LIBBY NOELLE LONGMAN PA

MEDICARE:   LIBBY NOELLE LONGMAN  PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA19269TX

General Provider Information

NPI Number : 1801773957
Entity Type Code : Individual
Provider Name (Legal Business Name) : LIBBY NOELLE LONGMAN PA
Provider Business Mailing Address
First Line : PO BOX 844658
Second Line :
City : DALLAS
State : TX
Zip : 75284-4658
Country : US
Telephone Number : 254-724-2111
Fax Number :
Provider Business Practice Location Address
First Line : 7700 FISH POND RD
Second Line :
City : WACO
State : TX
Zip : 76710-1031
Country : US
Telephone Number : 254-761-4444
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2025
Last Update Date : 01/21/2026

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Directions to “ LIBBY NOELLE LONGMAN PA” Practice Location

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