| NPI | 1275836736 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDACE WYNNE Credentialing 432-686-6605 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease |
| Enumeration Date | 2010-12-06 |
| Last Update Date | 2020-09-03 |