| NPI | 1740850742 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMISON ALEXANDER Owner 903-416-3650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology |
| Enumeration Date | 2021-06-30 |
| Last Update Date | 2022-03-18 |