| NPI | 1063613537 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKIE J TIBEDEAU Office Manager 940-382-4060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX G8687) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2013-06-05 |