NPI | 1760849558 |
---|---|
Entity Type | Organization |
Authorized Contact | DERRICK LOVE-JONES Owner 469-660-6767 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX AP125430) |
Enumeration Date | 2016-01-25 |
Last Update Date | 2016-05-11 |