| NPI | 1568572154 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY R MOORE Owner 325-641-8648 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX M0189) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-08-22 |