| NPI | 1841477999 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH ANN HENDERSON Office Manager 325-655-4259 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: TX G5298) |
| Enumeration Date | 2008-01-30 |
| Last Update Date | 2008-01-30 |