| NPI | 1710639620 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANYA LEWIS Owner/Administrator 254-651-1717 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2022-01-21 |
| Last Update Date | 2022-02-21 |