| NPI | 1184946212 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN HURT Health System Specialist 806-355-9703 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QV0200X Clinic/Center, VA (Licence: TX 33019) |
| Enumeration Date | 2010-02-16 |
| Last Update Date | 2010-02-16 |