| NPI | 1528451101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP D TALLEY Co Owner 432-352-4443 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TX AP127457) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: TX AP125677) |
| 261QU0200X Clinic/Center, Urgent Care (Licence: TX AP125677) | |
| 261QU0200X Clinic/Center, Urgent Care (Licence: TX AP127457) | |
| 261QX0100X Clinic/Center, Occupational Medicine (Licence: TX AP125677) | |
| 261QX0100X Clinic/Center, Occupational Medicine (Licence: TX AP127457) | |
| Enumeration Date | 2015-03-06 |
| Last Update Date | 2016-06-24 |