| NPI | 1225815343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASEY ATKINS Office Manager 979-239-8772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| Enumeration Date | 2023-09-12 |
| Last Update Date | 2023-11-06 |