| NPI | 1851233084 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JINGYI KANG Administrator 332-203-2522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 104100000X Social Worker |
| 172V00000X Community Health Worker | |
| 207QG0300X Family Medicine, Geriatric Medicine | |
| 207R00000X Internal Medicine | |
| 207RG0300X Internal Medicine, Geriatric Medicine | |
| 251B00000X Case Management | |
| 363LC1500X Nurse Practitioner, Community Health | |
| Enumeration Date | 2026-04-07 |
| Last Update Date | 2026-04-07 |