| NPI | 1104255272 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEFANIE FEEMSTER Credentialing Specialist 806-350-7325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| 363A00000X Physician Assistant | |
| 363LF0000X Nurse Practitioner Family | |
| 364SP0808X Clinical Nurse Specialist Psychiatric/Mental Health | |
| Enumeration Date | 2013-11-08 |
| Last Update Date | 2025-08-20 |