| NPI | 1508202110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORY HELMICK Administrator 915-755-2582 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2013-05-22 |
| Last Update Date | 2014-05-27 |