| NPI | 1124087028 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGEL POOLE Administrator 318-388-8878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: LA 0600001048) |
| Enumeration Date | 2006-03-20 |
| Last Update Date | 2015-06-04 |