| NPI | 1821289539 |
|---|---|
| Doing Business As | SENIOR CLINIC |
| Entity Type | Organization |
| Authorized Contact | BOB KAVISIC Office Manager 325-949-9408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX G5439) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: TX H4593) |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2007-08-07 |