| NPI | 1790134427 |
|---|---|
| Other Name | TEXAS |
| Entity Type | Organization |
| Authorized Contact | ASHLEY OAKS Operations Specialist 860-787-7416 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 208M00000X Hospitalist | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2016-06-03 |
| Last Update Date | 2016-06-03 |