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TEXARKANA KETAMINE CLINIC, PLLC
NPI 1528795317
Family Medicine in Texarkana, TX

Active since August 02, 2022
4110 RICHMOND PL, TEXARKANA, TX 75503(430) 294-0284(430) 294-0282 Get Directions Write a Review

NPPES record last updated: April 22, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 22, 2026, Jan 5, 2024, Aug 5, 2022 (3 updates tracked since 2022).

About Texarkana Ketamine Clinic, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TEXARKANA KETAMINE CLINIC, PLLC (NPI 1528795317), doing business as Transformative Wellness, is a healthcare organization registered as a family medicine in Texarkana, Texas and active in the NPI registry since August 2022. The organization lists John J Harris, Owner, as its authorized official.

NPPES Registry Identity

NPI1528795317
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameTEXARKANA KETAMINE CLINIC, PLLC
Location Address4110 RICHMOND PLTexarkana, TX 75503-0001
Mailing Address4110 Richmond PlTexarkana, TX 75503-0001 · (430) 294-0284 · Fax (430) 294-0282
Phone(430) 294-0284
Fax(430) 294-0282
Organization SubpartNo
Authorized OfficialJohn J HarrisOwner · (903) 733-3722
Enumeration DateAugust 2, 2022
Last NPPES UpdateApril 22, 20263 updates tracked since enumeration
NPPES CertifiedApril 22, 2026
✔ NPI 1528795317 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
4110 RICHMOND PL, Texarkana, TX 75503
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Other Names 1

Doing Business AsTransformative Wellness

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Texarkana Ketamine Clinic, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Texarkana Ketamine Clinic, PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

John Harris, M.D.
Family Practice
NPI 1194936013
4110 RICHMOND PL
Texarkana, TX 75503
(430) 294-0284
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Texarkana Ketamine Clinic, PLLC's NPI number?

The NPI number for Texarkana Ketamine Clinic, PLLC is 1528795317. It was assigned to this organization in the NPPES registry on August 2, 2022. The provider is doing business as Transformative Wellness.

Where is Texarkana Ketamine Clinic, PLLC located?

Texarkana Ketamine Clinic, PLLC is located at 4110 Richmond Pl, Texarkana, TX 75503. The listed phone number is (430) 294-0284.

What is Texarkana Ketamine Clinic, PLLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Texarkana Ketamine Clinic, PLLC enrolled in Medicare?

Yes. Texarkana Ketamine Clinic, PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Texarkana Ketamine Clinic, PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Texarkana Ketamine Clinic, PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Texarkana Ketamine Clinic, PLLC accept?

Health plans from Blue Cross and Blue Shield of Texas list Texarkana Ketamine Clinic, PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Texarkana Ketamine Clinic, PLLC was last updated on April 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.