| NPI | 1588347421 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JADA MARIE KHOSLA Owner 903-213-1005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2023-08-08 |
| Last Update Date | 2025-02-19 |