| 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 | 207Q00000X Family Medicine |
| 261QA0005X Clinic/Center, Ambulatory Family Planning Facility | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2024-06-13 |