| NPI | 1063027761 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALLAS LIPSCOMB Owner 575-744-4872 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 261QR1300X Clinic/Center, Rural Health | |
| Enumeration Date | 2020-09-10 |
| Last Update Date | 2025-04-08 |