| NPI | 1790232007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNA CONTRERAS Credentialing Manager 940-435-9044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2016-09-02 |
| Last Update Date | 2024-06-03 |