| NPI | 1164467742 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REYNA ELIZABETH VAQUERA Billing Manager 903-874-6711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP0905X Clinic/Center, Public Health, State or Local |
| Additional Taxonomies | 251K00000X Public Health or Welfare |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2025-09-11 |