| NPI | 1659036887 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE MANNING Owner 254-224-7700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2021-11-02 |
| Last Update Date | 2021-12-22 |