| NPI | 1841564929 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHI VANCE Office Manager 903-597-3787 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX E2095) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX D7080) |
| Enumeration Date | 2012-03-07 |
| Last Update Date | 2012-03-07 |