| NPI | 1750767364 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAYSIE N GARZA CEO 918-687-5477 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: OK 93131) |
| Enumeration Date | 2015-08-05 |
| Last Update Date | 2015-08-05 |