| NPI | 1629656178 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANITA CRISP Vice President Physician Services 979-543-5510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2021-03-29 |
| Last Update Date | 2021-03-29 |