| NPI | 1023430873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT DAVID KISTLER Owner 936-634-2231 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2014-01-14 |
| Last Update Date | 2014-02-04 |