| NPI | 1508753492 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER AWWAD Owner 662-665-1359 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2025-06-23 |
| Last Update Date | 2025-09-10 |