| NPI | 1902280902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON LAMKIN Consultant 936-414-4980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2015-07-20 |
| Last Update Date | 2015-09-28 |