| NPI | 1073909578 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE ROPPLE Lead Health Insurance Technician 254-288-8381 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1100X Clinic/Center Military/U.S. Coast Guard Outpatient |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2018-07-17 |