NPI | 1477950202 |
---|---|
Doing Business As | BRGP-BLUEBONNET FAMILY CLINIC |
Entity Type | Organization |
Authorized Contact | KENDALL JOHNSON C.F.O. 225-237-1645 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Enumeration Date | 2014-11-21 |
Last Update Date | 2022-09-06 |