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

Waco Functional Medicine, PA

Organization Family Medicine Physician · NPI 1093016826

Waco Functional Medicine, PA is a Family Medicine Physician in Waco, Texas. Licensed in Texas. Registered with an NPI since 2010.

Licensed in
TX
In the registry since
2010
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

318 Richland West Cir Ste B
Waco, TX 76712-7919
Phone: (254) 776-8009
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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 · Licence K3775 (TX)

Record details

NPI number1093016826
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lisa Kirk — Owner · (254) 776-8009
NPI enumeratedNovember 10, 2010
Last updated in NPPESNovember 10, 2010
Mailing address318 Richland West Cir Ste B, Waco, TX 76712-7919

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