| NPI | 1063819142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTOINETTE RENE NUNNELEY Owner 940-386-9334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX AP110354) |
| Enumeration Date | 2014-12-04 |
| Last Update Date | 2014-12-04 |