| NPI | 1447572599 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAY MARTIN Owner 325-643-3656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0000X Family Medicine, Adolescent Medicine (Licence: TX F4248) |
| Enumeration Date | 2010-02-17 |
| Last Update Date | 2010-02-17 |