| NPI | 1710449566 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSH CRAIG Manager/Owner 903-280-7716 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 208000000X Pediatrics |
| 363LP0200X Nurse Practitioner, Pediatrics | |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2024-08-22 |