| NPI | 1073793741 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANTIAGO REYES President 405-945-4495 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: OK 11652) |
| Enumeration Date | 2007-11-09 |
| Last Update Date | 2015-04-02 |