| NPI | 1194586057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DON MICHAEL THOMPSON Managing Member 737-358-9307 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine |
| Enumeration Date | 2024-01-18 |
| Last Update Date | 2024-01-26 |