| NPI | 1881043859 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAM SLATON COO 940-464-7222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX ap128462) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: TX 25085) |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2016-06-09 |