| NPI | 1740367838 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL DICKERSON Md 325-670-5320 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX J1517) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-08-22 |