| NPI | 1306119490 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY W HAMBERLIN Owner/Provider 972-563-1475 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 774755) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: TX 774755) |
| Enumeration Date | 2012-02-20 |
| Last Update Date | 2013-12-13 |