| NPI | 1104055342 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | FRANCES A GRANT Administrator 580-276-3320 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX D2622) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX J8958) | 
| Enumeration Date | 2009-07-09 | 
| Last Update Date | 2009-07-09 |