| NPI | 1942674296 |
|---|---|
| Doing Business As | COMMUNITY MEDICAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | HATSHEPSUT OSHUN Owner 267-242-3404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP128978) |
| Enumeration Date | 2015-11-24 |
| Last Update Date | 2024-03-05 |