| NPI | 1407409436 |
|---|---|
| Former Legal Business Name | PARMER LANE MEDICAL OFFICE LLC |
| Entity Type | Organization |
| Authorized Contact | BRIAN STUART EARTHMAN President/Owner 512-528-9498 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2019-07-18 |
| Last Update Date | 2019-07-18 |