| NPI | 1619166022 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLY L HUCKABY Nurse Practitioner/Owner 936-439-9830 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: TX 669836) |
| Enumeration Date | 2007-10-22 |
| Last Update Date | 2008-04-20 |