Organization Active NPI

Lansdell Family Clinic PLLC

  • Family Nurse Practitioner
  • Texarkana, TX
National Provider Identifier
1114534252
Registry record updated Sep 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
LANSDELL FAMILY CLINIC PLLC
Practice address
4102 Gibson LN
Texarkana, TX 75503-1120
Phone
(903) 255-7923
Fax
(866) 282-5926
NPI assigned
Sep 23, 2020
Organization subpart
Yes
Parent organization
LANSDELL FAMILY CLINIC PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 23, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Michael Wayne Lansdell
Title
Vice President
Phone
(870) 584-1053

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary
Gerontology Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LG0600X

Addresses

Primary practice location

4102 Gibson LN
Texarkana, TX 75503-1120

Mailing address

500 E Collin Raye Dr Ste 2
De Queen, AR 71832-8068
Phone (870) 584-1053

National Provider Directory

National Provider Directory
Part of
Lansdell Family Clinic PLLC

Locations

500 E Collin Raye Dr
Ste 2
De Queen, AR 71832
Phone (870) 584-1053

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1600819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600819200000",
    "number": "1114534252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 E COLLIN RAYE DR STE 2",
            "city": "DE QUEEN",
            "state": "AR",
            "postal_code": "718328068",
            "telephone_number": "870-584-1053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4102 GIBSON LN",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755031120",
            "telephone_number": "903-255-7923",
            "fax_number": "866-282-5926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANSDELL FAMILY CLINIC PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LANSDELL FAMILY CLINIC PLLC",
        "enumeration_date": "2020-09-23",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-23",
        "status": "A",
        "authorized_official_last_name": "LANSDELL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "870-584-1053"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.