| NPI | 1831757954 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SENTHIL K RAJU Provider 405-682-8383 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2019-06-04 |
| Last Update Date | 2019-08-09 |