| NPI | 1124569587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IYABO A ELEMUREN-OGUNMUYIWA Owner 254-699-8521 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX K4050) |
| Enumeration Date | 2017-03-17 |
| Last Update Date | 2017-03-17 |