| NPI | 1033891148 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSEMARY O VILLARREAL Credentialing Specialist 903-234-4226 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| 208D00000X General Practice | |
| 363A00000X Physician Assistant | |
| 363AM0700X Physician Assistant, Medical | |
| 363L00000X Nurse Practitioner | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2023-08-07 |
| Last Update Date | 2025-06-12 |