| NPI | 1689120529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SURYA PATEL Owner 270-547-7161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2016-08-31 |
| Last Update Date | 2016-08-31 |