| NPI | 1467599613 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT JERRY MAMLOK Owner 806-795-4391 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: TX H0596) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX H0596) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2010-06-21 |