| NPI | 1447769203 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RORY ALLEN Owner 940-231-4457 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| 363LF0000X Nurse Practitioner, Family | |
| 207QG0300X Family Medicine, Geriatric Medicine | |
| 363LG0600X Nurse Practitioner, Gerontology | |
| Enumeration Date | 2017-09-25 |
| Last Update Date | 2020-09-25 |