| NPI | 1558649996 |
|---|---|
| Former Legal Business Name | FSOP |
| Entity Type | Organization |
| Authorized Contact | KYLE E CULBERSON Program Director 940-484-7837 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: TX 16645) |
| Enumeration Date | 2011-08-03 |
| Last Update Date | 2011-08-03 |