| NPI | 1689813651 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN M MALONEY Owner 254-773-3248 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: TX 3499T) |
| Enumeration Date | 2009-02-13 |
| Last Update Date | 2009-08-18 |