| NPI | 1578441200 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAGADEESH JAGARLAMUDI Operations Administrator 332-296-0021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2025-08-21 |
| Last Update Date | 2025-08-21 |