NPI | 1821481714 |
---|---|
Entity Type | Organization |
Authorized Contact | DURRELL JEFFERY C.E.O. 940-735-0604 |
Organization Subpart ? | No |
Primary Taxonomy | 302R00000X Health Maintenance Organization |
Additional Taxonomies | 302F00000X Exclusive Provider Organization |
305R00000X Preferred Provider Organization | |
305S00000X Point of Service | |
Enumeration Date | 2015-03-17 |
Last Update Date | 2015-03-17 |