KELL WEST FAMILY PRACTICE CLINIC (NPI# 1073565685) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073565685 |
| Entity Type | Organization |
| Organization Name | KELL WEST FAMILY PRACTICE CLINIC |
| Practice Address |
5500 Kell West Blvd Suite 400 Wichita Falls TX 76310-1612 |
| Mailing Address |
5500 Kell Blvd Suite 400 Wichita Falls TX 76310-1612 |
| Practice Telephone | 9406960011 |
| Practice Fax Number | 9406962248 |
| Mailing Telephone | 9406960011 |
| Mailing Fax Number | 9406962248 |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. MICHEAL ALLAN MOISANT (GENERAL PARTNER) |
| Authorized Official Telephone | 9406960011 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BCBS OF TEXAS | 0078HQ | 01 |
| TX | RAILROAD MEDICARE | CK5579 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811304090 | Kell West Family Practice Clinic | Clinic/Center | 4412 Kell Blvd, Wichita Falls, TX 76309-4719 | 2014-07-19 |
| Street Address |
5500 KELL WEST BLVD SUITE 400 |
| City | WICHITA FALLS |
| State | TX |
| Zip Code | 76310-1612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629295621 | Kell Primary Care Pa | Family Medicine | 5500 Kell West Blvd, Suite 500, Wichita Falls, TX 76310 | 2007-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205329067 | Alesha Lynn Dean | Licensed Vocational Nurse | 6211 Talon Trail, Wichita Falls, TX 76310 | 2018-06-07 |
| 1962766741 | Kimberly D'anne Ravelo | Audiologist | 1 Burnside Drive, Wichita Falls, TX 76310 | 2012-06-27 |
| 1407142417 | Tobin Strom | Radiology | Texas Oncology, 5400 Kell West Blvd, Wichita Falls, TX 76310 | 2011-06-28 |
| 1386850055 | D&s Residential Services | Intermediate Care Facility, Mentally Retarded | 6086 Kovarik Road, Wichita Falls, TX 76310 | 2007-05-16 |
| 1639391394 | Amy Louise Walmsley | Pharmacist | 1724 Woodridge Dr, Wichita Falls, TX 76310 | 2007-05-03 |
| 1619007416 | Stephanie Joy Postma | Specialist/Technologist | #1 West Medical Court, Wichita Falls, TX 76310 | 2007-03-07 |
| 1568518306 | Bestcare Health Services,inc | Home Health | 5800 Kell West Blvd, Suite 500, Wichita Falls, TX 76310 | 2007-01-26 |
| 1851453856 | Anthony Armando Denis Noya | Family Medicine | 8 Prairie Lace Court, Wichita Falls, TX 76310 | 2006-12-15 |
| 1467872127 | William Russell | Family Medicine | 4327 Barnett Rd, Wichita Falls, TX 76310 | 2014-04-22 |
| 1528297256 | Vanya David Wagler | Internal Medicine | 4327 Barnett Rd, Wichita Falls, TX 76310 | 2009-07-02 |
| Find all providers in zip 76310 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649755570 | Wichita Medical Management, LLC | Clinic/Center | 3701 Fairway Blvd Ste 114, Wichita Falls, TX 76310-1038 | 2018-09-26 |
| 1255324141 | North Central Texas Community Health Care Center Inc | Clinic/Center | 200 Mlkjr Blvd, Wichita Falls, TX 76301-1152 | 2005-08-25 |
| 1942793864 | Harmony Integrative Medicine Clinics, Pllc | Clinic/Center | 4412 Kell Blvd, Wichita Falls, TX 76309-4719 | 2018-06-14 |
| 1336521731 | Invigorate Men's Health & Wellness, Pllc | Clinic/Center | 4001 Cedar Elm Ln, Suite B, Wichita Falls, TX 76308-3031 | 2015-06-22 |
| 1811304090 | Kell West Family Practice Clinic | Clinic/Center | 4412 Kell Blvd, Wichita Falls, TX 76309-4719 | 2014-07-19 |
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| Find all providers with the same taxonomy | ||||
| City | WICHITA FALLS |
| Zip Code | 76310 |
Please comment or provide details below to improve the information on KELL WEST FAMILY PRACTICE CLINIC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.