Organization · Type 2 NPI

Rustic Roots Family Care PLLC

Family Nurse Practitioner · Longview, TX

NPI number 1124934948 Active

Practice location

1328 Heritage Blvd
Longview, TX 75605-1472

Call (903) 228-2728 Map

Mailing address

PO Box 162
White Oak, TX 75693-0162

Specialties and licenses

TaxonomyCodeLicense
Counselor 101Y00000XNone listed
Family Medicine Physician 207Q00000XNone listed
Obesity Medicine (Preventive Medicine) Physician 2083B0002XNone listed
Family Nurse Practitioner Primary 363LF0000XNone listed
Primary Care Nurse Practitioner 363LP2300XNone listed

Family Nurse Practitioner: Definition to come...

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About NPI 1124934948

Rustic Roots Family Care PLLC's National Provider Identifier is 1124934948, issued on Aug 21, 2026. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Longview, TX. The record was last updated on Oct 1, 2026.