| NPI | 1770973414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOE F TITTLE Director 915-204-3562 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 612956) |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2015-02-03 |
| Last Update Date | 2018-10-10 |