| NPI | 1346923273 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBIN BRULE CFO 903-792-7435 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2023-08-08 |
| Last Update Date | 2023-08-08 |