| NPI | 1285138347 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVAN PAWLOWICZ Owner 903-331-0506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: TX N1829) |
| Enumeration Date | 2018-03-22 |
| Last Update Date | 2018-03-22 |