| NPI | 1942049291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTAN L BANNISTER President 915-289-2100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 364SP0813X Clinical Nurse Specialist, Psych/Mental Health, Geropsychiatric |
| Enumeration Date | 2024-05-24 |
| Last Update Date | 2024-06-24 |