| NPI | 1033388509 |
|---|---|
| Doing Business As | QUARTZ MOUNTAIN MEDICAL CLINIC - MANGUM |
| Entity Type | Organization |
| Authorized Contact | SHANA DAVENPORT Insurance Credentialing Supervisor 512-681-3460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: OK 2208) |
| Enumeration Date | 2008-02-28 |
| Last Update Date | 2009-03-04 |