NPIMap

Organization Active NPI

Wichita Medical Management, LLC

  • Primary Care Clinic/Center
  • Wichita Falls, TX
National Provider Identifier
1649755570
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
WICHITA MEDICAL MANAGEMENT, LLC
Practice address
3701 Fairway Blvd Ste 114
Wichita Falls, TX 76310-1038
Phone
(325) 701-9270
NPI assigned
Sep 26, 2018
Last updated
Aug 15, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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

Authorized official

Name
Steven Trace George
Title
Chief Operating Officer
Phone
(325) 701-9270

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary
Family Medicine Physician 207Q00000X

Addresses

Primary practice location

3701 Fairway Blvd Ste 114
Wichita Falls, TX 76310-1038

Mailing address

PO Box 6807
Abilene, TX 79608-6807
Phone (325) 701-9270

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1537920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660521600000",
    "number": "1649755570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6807",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796086807",
            "telephone_number": "325-701-9270",
            "fax_number": "325-701-9272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 FAIRWAY BLVD STE 114",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763101038",
            "telephone_number": "325-701-9270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WICHITA MEDICAL MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-26",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A",
        "authorized_official_last_name": "GEORGE",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "TRACE",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "325-701-9270"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita Falls, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.