| NPI | 1659012839 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREY SHALOMOV President 254-774-1163 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2024-11-22 |