Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Texarkana Ketamine Clinic, PLLC

Organization Family Medicine Physician · NPI 1528795317

Texarkana Ketamine Clinic, PLLC provides Family Medicine Physician services in Texarkana, Texas. Registered with an NPI since 2022.

In the registry since
2022
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4110 Richmond Pl
Texarkana, TX 75503-0001
Phone: (430) 294-0284
Fax: (430) 294-0282
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1528795317
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official John Harris — Owner · (903) 733-3722
Other names Transformative Wellness
NPI enumeratedAugust 2, 2022
Last updated in NPPESApril 22, 2026
Certification dateApril 22, 2026
Mailing address4110 Richmond Pl, Texarkana, TX 75503-0001

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