| NPI | 1275882128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDY EDWIN JOHNSON Executive Director 936-523-5113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse |
| Additional Taxonomies | 251K00000X Public Health or Welfare |
| 261Q00000X Clinic/Center | |
| Enumeration Date | 2012-09-06 |
| Last Update Date | 2012-11-26 |