Provider Type Icon

WACO FUNCTIONAL MEDICINE PA NPI 1093016826


NPI Information

NPI: 1093016826
Provider Name: WACO FUNCTIONAL MEDICINE, PA
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
318 RICHLAND WEST CIR STE B
WACO, TX
ZIP 76712
Phone: (254) 776-8009
Get Directions

WACO FUNCTIONAL MEDICINE, PA is a family medicine in Waco, TX. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. WACO FUNCTIONAL MEDICINE, PA NPI is 1093016826. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

318 RICHLAND WEST CIR STE B
WACO, TX
ZIP 76712-919
Phone: (254) 776-8009

The provider's authorized official is Lisa J Kirk .
The authorized official title is Owner and has the following contact phone number (254) 776-8009.

The enumeration date for this NPI number is 11/10/2010 and was last updated on 11/10/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineK3775TEXASYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.