| NPI | 1902073208 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETTY JO JORDAN Nurse Practitioner 936-257-1102 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 509147) |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2008-05-15 |