| NPI | 1447915277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN JACOB CAMERON Manager 903-501-5056 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2021-11-05 |
| Last Update Date | 2021-12-02 |