| NPI | 1649417809 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE DIANES HACKER Nurse Practitioner 940-641-3601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 658966) |
| Enumeration Date | 2009-01-09 |
| Last Update Date | 2024-05-13 |