| NPI | 1497202063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE LEE WIGGINS-WORTHY Owner 432-268-9152 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TX AP131710) |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2016-11-03 |