NPI | 1023631678 |
---|---|
Doing Business As | MEHOP WHARTON PRIMARY |
Entity Type | Organization |
Authorized Contact | MANUELA LUNA Provider Enrollment Coordinator 979-245-2008 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2020-05-18 |
Last Update Date | 2023-04-28 |