| NPI | 1205877180 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BECKY J SANDERS Office Manager 903-893-5546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TX l2057) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: TX l2057) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2018-07-11 |