| NPI | 1598959389 |
|---|---|
| Doing Business As | FAMILY MEDICINE CLINIC |
| Entity Type | Organization |
| Authorized Contact | IYABO BOLA ELEMUREN Owner 254-699-8521 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX K4050) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA01547) |
| Enumeration Date | 2007-09-05 |
| Last Update Date | 2012-01-10 |