NPI 1235402447

Keith Austin Wommack, CSB

Practitioner Religious Nonmedical Practitioner Corpus Christi, TX

Practice location

Address: 514 Ronson Dr, Corpus Christi, TX 78412-3152
Phone: (361) 992-2487
Fax: (361) 991-6310

Registered specialties

Religious Nonmedical Practitioner Primary

Nursing Service Related Providers Taxonomy 374K00000X

Other Religious Nonmedical Practitioner providers in Texas →

Registry record

NPI: 1235402447
Entity type: Individual
Sex (as registered): Male
NPI issued: 17 Feb 2012
Record last updated: 17 Feb 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.