| NPI | 1639368764 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARROLL WAYNE THORNBURG Physician/Owner 915-842-0990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: TX G9230) |
| Enumeration Date | 2007-10-15 |
| Last Update Date | 2016-06-19 |