| NPI | 1063200137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBIN FULLER Executive Director Of Finance 979-436-0398 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2025-04-29 |
| Last Update Date | 2025-04-29 |