| NPI | 1447374921 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VENKAT N. MALLEPALLI President 318-388-8561 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: LA 12443R) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2019-06-26 |