| NPI | 1144485756 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOMMY MCMAHON Administrator 325-949-9555 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2008-07-23 |
| Last Update Date | 2018-12-05 |