| NPI | 1104040591 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD B DEBENEDETTO Owner 806-236-5938 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: TX J9579) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX J9579) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2020-08-22 |