| NPI | 1114426756 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOLLY M AUGUSTUS Owner/Employee 903-721-0865 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX AP136353) |
| Enumeration Date | 2018-02-09 |
| Last Update Date | 2019-06-14 |