| NPI | 1043686686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FERN ANGELA CAUDLE Registered Nurse 580-504-9976 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: OK 74581) |
| Enumeration Date | 2015-08-18 |
| Last Update Date | 2015-08-18 |