| NPI | 1124012935 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN LEE BOLES Operational Manager 903-408-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 261QR1300X Clinic/Center, Rural Health (Licence: TX 458973) | |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2025-01-31 |