| NPI | 1851586853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLIS GERARD MAIN Owner 361-241-6700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX J2176) |
| Additional Taxonomies | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2022-08-15 |