| NPI | 1114039419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUBEL KEITH REED CEO 432-684-4488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA03316) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-08-22 |