| NPI | 1952061194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA MARIE CAPEHEART Owner/ Practitioner 903-223-5931 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2021-12-29 |
| Last Update Date | 2021-12-29 |