| NPI | 1619618964 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SRINIVASA REDDY YERASI Pediatrician 337-332-3971 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 208000000X Pediatrics | |
| Enumeration Date | 2022-04-01 |
| Last Update Date | 2023-01-20 |