| NPI | 1053905943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER BOWMAN Director Of Administration 280-967-5608 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2021-02-22 |
| Last Update Date | 2021-03-12 |