| NPI | 1942574918 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN JAKES PANG Md/Owner 254-935-2655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine Geriatric Medicine (Licence: TX K5175) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX K5175) |
| Enumeration Date | 2012-03-08 |
| Last Update Date | 2012-07-01 |