| NPI | 1912191420 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY GREWING Administrator 940-634-1699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2022-09-19 |