| NPI | 1790239911 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY VAUGHN Credentailing Coordinator 940-320-1708 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology |
| Enumeration Date | 2016-08-04 |
| Last Update Date | 2018-07-11 |