| NPI | 1942330733 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY L FREELEN Office Coordinator 903-784-1593 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: TX J7476) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2013-01-09 |