| NPI | 1689659765 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS P SELSOR CFO 940-325-7891 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center Rural Health (Licence: TX 34) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2005-12-12 |
| Last Update Date | 2025-08-08 |