| NPI | 1760653976 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN SOWDER COO 940-384-6238 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2008-03-14 |
| Last Update Date | 2008-10-17 |