| NPI | 1053985879 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP MOORE Owner 903-819-6385 |
| Organization Subpart ? | No |
| Primary Taxonomy | 231H00000X Audiologist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103TC1900X Psychologist, Counseling | |
| 207Y00000X Otolaryngology | |
| 2084N0400X Psychiatry & Neurology, Neurology | |
| 363A00000X Physician Assistant | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2021-05-17 |
| Last Update Date | 2021-05-17 |