Provider Demographics
NPI:1013631019
Name:WEST TEXAS OPTIMAL HEALTH
Entity Type:Organization
Organization Name:WEST TEXAS OPTIMAL HEALTH
Other - Org Name:WEST TEXAS OPTIMAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NURSE PRACTITIONER/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:ACEVEDO
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:806-241-1664
Mailing Address - Street 1:915 AUSTIN ST
Mailing Address - Street 2:
Mailing Address - City:LEVELLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79336-4421
Mailing Address - Country:US
Mailing Address - Phone:806-310-2715
Mailing Address - Fax:
Practice Address - Street 1:915 AUSTIN ST
Practice Address - Street 2:
Practice Address - City:LEVELLAND
Practice Address - State:TX
Practice Address - Zip Code:79336-4421
Practice Address - Country:US
Practice Address - Phone:806-310-2715
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-03
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care