| NPI | 1942876701 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALANNAH MICHELLE SPINKS Office Manager 936-854-2273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2021-06-02 |
| Last Update Date | 2025-09-26 |