| NPI | 1891796694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLIE MACH CFO 254-202-9450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207L00000X Anesthesiology |
| 207N00000X Dermatology | |
| 207P00000X Emergency Medicine | |
| 207R00000X Internal Medicine | |
| 207V00000X Obstetrics & Gynecology | |
| 207W00000X Ophthalmology | |
| 207X00000X Orthopaedic Surgery | |
| 207Y00000X Otolaryngology | |
| 208000000X Pediatrics | |
| 208200000X Plastic Surgery | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 2085R0202X Radiology, Diagnostic Radiology | |
| 208600000X Surgery | |
| 213E00000X Podiatrist | |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2024-03-21 |