| NPI | 1538663877 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY CATHERINE MOODY Owner 903-887-8884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP126911) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX AP126911) |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2018-03-21 |