| NPI | 1780802504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONYA CLAYTON President 318-671-9309 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: LA 023335) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 023335) |
| 208000000X Pediatrics (Licence: LA 023335) | |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2020-08-22 |