| NPI | 1093269904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL SULLIVAN President 806-765-2611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: TX 32133) |
| Enumeration Date | 2016-08-09 |
| Last Update Date | 2016-08-09 |