NPI | 1386210441 |
---|---|
Doing Business As | TWELVE52 CLINIC |
Entity Type | Organization |
Authorized Contact | TAMEKA ROYAL Nurse Practitioner 903-399-4521 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
Enumeration Date | 2021-05-31 |
Last Update Date | 2021-09-17 |