| NPI | 1699943191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOE ANN MOORE Manager 806-249-8324 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA00540) |
| Enumeration Date | 2008-02-19 |
| Last Update Date | 2008-02-19 |