| NPI | 1871761338 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRIE THOMAS Administrative Assistant 409-835-4907 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX LO828) |
| Enumeration Date | 2008-02-18 |
| Last Update Date | 2017-10-11 |