| NPI | 1124782875 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTY R. SUMMERALL CEO 903-851-0727 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2021-10-28 |
| Last Update Date | 2025-02-12 |