| NPI | 1003148917 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASSIE TEMPLE Patient Care Coordinator 806-368-3632 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TX N4592) |
| Enumeration Date | 2010-02-02 |
| Last Update Date | 2016-01-04 |