| NPI | 1225702467 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARETHA HORTON Practice Manager 936-439-4608 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2021-08-02 |
| Last Update Date | 2021-08-02 |