| NPI | 1922556067 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM NESVIG Executive Director 903-212-7170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2016-09-19 |
| Last Update Date | 2016-09-19 |