| NPI | 1265264261 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL JASON CHASTANT Nurse Practitioner 903-707-0144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care |
| Enumeration Date | 2024-08-17 |
| Last Update Date | 2024-08-17 |