| NPI | 1467132498 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHILEEN BOOZER Owner 254-343-7919 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 261QH0100X Clinic/Center Health Service |
| 261QM2500X Clinic/Center Medical Specialty | |
| Enumeration Date | 2023-07-24 |
| Last Update Date | 2025-05-28 |