OrganizationActive
Old Corner Wellness Inc
NPI 1003514597 · Adult Health Nurse Practitioner · West, TX
Provider details
- NPI number
- 1003514597
- Entity type
- Organization
- Primary specialty
- Adult Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Randy Niemeyer, Owner(254) 826-5122
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
- Clinic/Center261Q00000X
Ambulatory Health Care Facilities
Practice location
200 N Main St
West, TX 76691-1207
Phone: (254) 826-5122
Approximate (ZIP-level) locationGet directions
Mailing address
200 N Main St
West, TX 76691-1207
Registry dates
- Enumerated
- 2023-02-23
- Last updated
- 2024-06-04
- Certified
- 2024-06-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.