| NPI | 1639115132 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN RANDALL VP Administration 318-212-3520 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 208000000X Pediatrics | |
| 2083X0100X Preventive Medicine, Occupational Medicine | |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2015-10-27 |