| NPI | 1841201092 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE RUSSELL Credentialing Coordinator 806-354-5495 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207V00000X Obstetrics & Gynecology | |
| 208000000X Pediatrics | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 208600000X Surgery | |
| 291U00000X Clinical Medical Laboratory | |
| 225100000X Physical Therapist | |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2013-11-11 |