| NPI | 1790501583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANA S AMOABEA Owner 469-257-3500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health |
| Enumeration Date | 2024-11-26 |
| Last Update Date | 2025-11-07 |