| NPI | 1891473088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TALYNN HARVEY Member 432-559-4329 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2023-07-07 |
| Last Update Date | 2023-07-07 |