| NPI | 1639453475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY L. REYNOLDS Managing Partner 903-791-9355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2011-09-28 |
| Last Update Date | 2017-12-13 |