| NPI | 1134606395 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL CHRISTOPHER NOWAK Owner 915-545-2600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TX K5366) |
| Enumeration Date | 2018-07-20 |
| Last Update Date | 2018-07-20 |