| NPI | 1346844347 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENARJI TEGALA Owner 903-226-9614 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2020-11-30 |
| Last Update Date | 2020-12-03 |