| NPI | 1578932109 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIM MARTIN Physician 325-232-8675 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 174H00000X Health Educator (Licence: TX K2958) |
| Enumeration Date | 2015-09-24 |
| Last Update Date | 2023-03-07 |