| NPI | 1750655106 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY R MEADOWS Vice President 469-401-2386 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2012-03-02 |
| Last Update Date | 2015-01-28 |