| NPI | 1558543553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY M MEHLHAFF Phsician Assistant 940-626-0052 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: TX PA00495) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: TX PA00495) |
| Enumeration Date | 2007-11-30 |
| Last Update Date | 2007-11-30 |