| NPI | 1902549223 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICARDO SWATTS Administrator 915-487-9923 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 2084P0805X |
| Enumeration Date | 2022-04-14 |
| Last Update Date | 2025-05-06 |