| NPI | 1811563497 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SERESEA MITCHELL-SMITH Nurse Practioner 254-781-6772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2021-06-03 |
| Last Update Date | 2024-09-26 |