| NPI | 1184762510 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANNE WOMACK Registered Nurse 254-462-2378 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty (Licence: TX 577932) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2020-08-22 |