| NPI | 1225386071 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HENRY P LUCKETT President 903-595-2211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: TX E6130) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: TX E6130) |
| Enumeration Date | 2012-08-28 |
| Last Update Date | 2012-10-04 |