| NPI | 1114188943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE ANN JOHNSON President 254-732-4139 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2008-06-24 |