| NPI | 1215522974 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLEN W ROBISON CEO 903-603-9851 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 261QC1500X Clinic/Center, Community Health | |
| Enumeration Date | 2021-03-04 |
| Last Update Date | 2023-10-18 |