| NPI | 1730567462 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA MOSOMI Nurse Practitioner 682-220-9615 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX 748914) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2015-05-14 |
| Last Update Date | 2023-04-17 |