| NPI | 1568658920 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY J. BLANTON Office Manager 903-595-6078 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX H4166) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TX 30239) |
| 111N00000X Chiropractor (Licence: TX DC5099) | |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: TX H4166) | |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: TX H4166) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: TX H4166) | |
| Enumeration Date | 2007-09-19 |
| Last Update Date | 2007-10-27 |