NPI | 1255367090 |
---|---|
Entity Type | Organization |
Authorized Contact | ANITA K HUMPHREYS CFO 936-560-5413 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology |
207Q00000X Family Medicine | |
261QA0005X Clinic/Center, Ambulatory Family Planning Facility | |
261QM1300X Clinic/Center, Multi-Specialty | |
Enumeration Date | 2006-06-23 |
Last Update Date | 2025-09-16 |