| NPI | 1346572880 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GWENDOLYN JOYCE ALLEN Owner 325-646-5296 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363LF0000X Nurse Practitioner, Family | |
| 207Q00000X Family Medicine (Licence: TX G4784) | |
| Enumeration Date | 2010-02-09 |
| Last Update Date | 2021-05-27 |