| NPI | 1265840268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREG J GAVIN Network Administrator 318-212-8780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism |
| Enumeration Date | 2014-07-23 |
| Last Update Date | 2014-07-23 |