| NPI | 1932486651 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH K PHILLIPS Owner 903-736-3337 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2011-11-09 |
| Last Update Date | 2019-01-09 |