| NPI | 1417484114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LONNIE DEGGINS Director 936-499-3720 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TX 08693) |
| 163W00000X Registered Nurse (Licence: TX 568702) | |
| Enumeration Date | 2017-05-12 |
| Last Update Date | 2017-05-12 |