| NPI | 1427348168 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH JOHN BONNER Managing Member 940-387-7300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 675701) |
| Enumeration Date | 2011-04-14 |
| Last Update Date | 2011-12-06 |