| NPI | 1679440952 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON K DAVIS Owner/Nurse Practitioner 254-349-6008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-10-21 |
| Last Update Date | 2025-10-21 |