| NPI | 1790172526 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY HAMMOND Co/Owner 325-690-0620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: TX K0123) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: TX K0123) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 594982) | |
| Enumeration Date | 2015-04-20 |
| Last Update Date | 2015-04-20 |