| NPI | 1104385095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL DAVID HUCKABEE COO 318-751-9100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 207P00000X Emergency Medicine |
| 261QP2000X Clinic/Center, Physical Therapy | |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2019-07-29 |