| NPI | 1912685371 |
|---|---|
| Other Name | N/A |
| Entity Type | Organization |
| Authorized Contact | AMBER RACHELLE ROGERS Physician, Owner 682-367-0703 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2023-07-06 |
| Last Update Date | 2023-07-06 |