| NPI | 1710621792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA DIONNE OWENS Family Nurse Practitioner 409-832-6129 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2022-04-25 |
| Last Update Date | 2022-04-25 |