| NPI | 1770571598 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE GIBSON-BURRIS Practice Management Manager 580-249-3706 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: OK 8721) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: OK 11867) |
| 363LX0001X Nurse Practitioner Obstetrics & Gynecology (Licence: OK R0048498) | |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2011-02-21 |