| NPI | 1801264775 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN E KIRK Managing Member 940-631-7066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 679387) |
| Enumeration Date | 2015-09-09 |
| Last Update Date | 2017-01-11 |