| NPI | 1841614021 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALI JAFFAR Owner 806-352-7200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: TX K1843) |
| Enumeration Date | 2014-02-10 |
| Last Update Date | 2014-02-10 |