| NPI | 1003264425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD RICKY SOUTHARD Administrator 806-797-6398 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2016-05-26 |
| Last Update Date | 2016-05-26 |