Indavong Phonasa is one of 47 nurse practitioners practicing in Mineral Wells, Texas .
Indavong Phonasa practices with Palo Pinto County Hospital District.
Registry record (NPPES)
NPI
1912356130
Type
Type 1 · Individual
Primary taxonomy
Nurse Practitioner, Family · 363LF0000X
Address on file
605 E 4th St
Enumerated
Jun 8, 2016
Record last updated
Jun 8, 2016
License states listed
TX
Medicare (CMS)
Enrollment
Medicare-enrolled in TXNurse Practitioner
Revalidation due
No date set by CMS
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Part D prescribing
Procedure volumes by CPT code
Group affiliations and colleagues
Full enrollment history
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Practice locations
101 Holly Hill RdMineral Wells , TX 76067
101 Holly Hill Rd Suite BMineral Wells , TX 76067
202 SW 25th AveMineral Wells , TX 76067
202 SW 25th Ave 1200 Palo Pinto UrologyMineral Wells , TX 76067
202 SW 25th Ave 300 Palo Pinto General HospitalMineral Wells , TX 76067
202 SW 25th Ave 800 Palo Pinto Cares For KidsMineral Wells , TX 76067
202 SW 25th St 800 Palo Pinto General Hospital PulmonologyMineral Wells , TX 76067
400 SW 25th AveMineral Wells , TX 76067
400 SW 25th Ave Palo Pinto General HospitalMineral Wells , TX 76067
More nurse practitioners in Mineral Wells
Updated August 2026. Practice locations and specialty come from the CMS Doctors and Clinicians file, the registry record from NPPES, and enrollment from CMS Medicare enrollment files. NPI records are corrected at the source, through NPPES.
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