| NPI | 1932790110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MYLINH SEAGULL Telehealth 817-381-9858 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QR1300X Clinic/Center Rural Health | |
| Enumeration Date | 2021-01-29 |
| Last Update Date | 2023-03-07 |