| NPI | 1467945865 |
|---|---|
| Doing Business As | PURE G KIDS WELLNESS |
| Entity Type | Organization |
| Authorized Contact | TAMIKA BUSH CEO 432-701-0093 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX RO366) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2019-07-22 |