| NPI | 1124614839 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAMILAH J PAYNE Owner 832-616-0698 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2020-12-16 |
| Last Update Date | 2023-02-15 |