| NPI | 1720488646 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT CHOWNING Manager 405-312-9773 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TX P3521) |
| Enumeration Date | 2014-08-27 |
| Last Update Date | 2014-08-27 |