| NPI | 1578174074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERRY LYNNE CLARK Billing/Credentialing 580-223-5180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine |
| Enumeration Date | 2020-08-10 |
| Last Update Date | 2020-08-10 |