| NPI | 1063407922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA CATHEY Reimbursements/Contracts 254-968-6051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX E9244) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX L2522) |
| 208000000X Pediatrics (Licence: TX K6312) | |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 251622) | |
| 363LW0102X Nurse Practitioner, Women's Health (Licence: TX 456297) | |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2022-10-06 |