| NPI | 1679384853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AHMER ISHTIAQ Owner 903-280-6738 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2025-01-16 |
| Last Update Date | 2025-03-03 |