| NPI | 1124446836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW E WICK Owner 325-672-3252 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TX P5147) |
| Enumeration Date | 2014-03-31 |
| Last Update Date | 2019-03-22 |