| NPI | 1851596423 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARSHA EVETTE THIGPEN Sole Proprietor 409-729-5629 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: TX H1224) |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2020-08-22 |