| NPI | 1083085385 |
|---|---|
| Doing Business As | SOUTHWEST ANTI-AGING CENTER |
| Entity Type | Organization |
| Authorized Contact | KATHLEEN ANNE CLARK Md 806-350-7311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX P8871) |
| Enumeration Date | 2015-10-13 |
| Last Update Date | 2017-11-09 |