| NPI | 1225265598 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT E LYON Owner 318-281-3432 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA 014103) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA 015059) |
| Enumeration Date | 2009-06-15 |
| Last Update Date | 2009-06-15 |