| NPI | 1841628211 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA GRACIELA ORTEGA Billing Manager 806-213-9560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 101YP2500X Counselor, Professional | |
| 261QR0200X Clinic/Center, Radiology (Licence: TX R40503) | |
| 261QR1300X Clinic/Center, Rural Health | |
| 291U00000X Clinical Medical Laboratory (Licence: TX 45D2116379) | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2013-10-23 |
| Last Update Date | 2020-06-19 |