| NPI | 1033186499 |
|---|---|
| Other Name | AGENCY OF THE STATE OF TEXAS |
| Entity Type | Organization |
| Authorized Contact | JENNIFER K GOODE CEO Chief Executive Officer 325-690-5135 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2006-03-03 |
| Last Update Date | 2020-08-22 |