| NPI | 1104541390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANETTE SCHAUBLIN Aco Coordinator 903-247-0525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2022-10-10 |
| Last Update Date | 2022-10-17 |