| NPI | 1184949901 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN BOWMAN Owner 254-773-5677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: TX 5046) |
| Enumeration Date | 2010-04-05 |
| Last Update Date | 2010-04-05 |