NPI | 1639574130 |
---|---|
Entity Type | Organization |
Authorized Contact | TIMOTHY L. REYNOLDS Managing Partner 903-791-9355 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
261QU0200X Clinic/Center, Urgent Care | |
261QX0100X Clinic/Center, Occupational Medicine | |
Enumeration Date | 2014-10-27 |
Last Update Date | 2017-12-13 |