| NPI | 1124721410 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA JAYNE ROWORTH-CHAIKIN Physician Owner 903-315-3966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2023-03-24 |
| Last Update Date | 2023-03-24 |