NPI | 1184162901 |
---|---|
Entity Type | Organization |
Authorized Contact | THADDEUS TURNER Administrator 940-280-2332 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP117119) |
Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: TX F0916) |
Enumeration Date | 2017-02-01 |
Last Update Date | 2017-02-01 |