Ketamine Health & Wellness Center of Texas

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

L4969 Issued in TX

Legal business name

KETAMINE HEALTH & WELLNESS CENTER OF TEXAS

Practice address

5944 W Parker Rd Ste 400
Plano, TX 75093-6443

Phone

(972) 980-0500

Fax

(972) 980-0503

NPI assigned

Jul 13, 2017

Organization subpart

No

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

Authorized official

Name

Mrs. Leslie K Hill

Title

Billing Manager

Phone

(972) 980-0500

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1499904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1295257988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5944 W PARKER RD STE 400",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750936443",
            "telephone_number": "972-980-0500",
            "fax_number": "972-980-0503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5944 W PARKER RD STE 400",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750936443",
            "telephone_number": "972-980-0500",
            "fax_number": "972-980-0503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KETAMINE HEALTH & WELLNESS CENTER OF TEXAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-13",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "HILL",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "972-980-0500",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "TX",
            "license": "L4969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Kersjes, OD
• Keshava G Suresh MD PA
• Melanie Kessler, M.S., CCC-SLP
• Caroline Kesterson, FNP
• Edwin Kestler, RPH
• Jeffrey Judge Ketzle, A.C.N.P.
• Tiffany Merrill Ketzle, APRN ANP-C
• Craig Keuchel
• Kevin Lunde, M.D., P.a.
• Kasey Key, LPC

• Pain Medicine (Anesthesiology) Physician in Plano, TX
• Providers in Plano, TX by specialty
• Pain Medicine (Anesthesiology) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.