| NPI | 1568191492 |
|---|---|
| Doing Business As | WACO FAMILY MEDICINE - MADISON COOPER |
| Entity Type | Organization |
| Authorized Contact | MATTHEW POLK COO 254-313-4412 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2022-06-07 |
| Last Update Date | 2022-06-07 |