| NPI | 1871833251 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHI HERRIN Manager 936-788-6060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2013-02-22 |
| Last Update Date | 2020-02-27 |