| NPI | 1144262296 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAXINE A THERIOT President 972-816-0459 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine Undersea and Hyperbaric Medicine (Licence: TX J9578) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX J9578) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2023-07-13 |