| NPI | 1730929175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY AGBA CEO 409-356-9778 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-05-31 |
| Last Update Date | 2024-05-31 |