| NPI | 1184057481 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERNON HOLMES CEO 667-770-6320 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 208D00000X General Practice | |
| 261QC1500X Clinic/Center Community Health | |
| 261QH0100X Clinic/Center Health Service | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2013-08-10 |
| Last Update Date | 2025-07-12 |