| NPI | 1952865495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIRANDA SKAGGS Practice Manager 254-760-0283 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 251G00000X Hospice Care, Community Based |
| 363L00000X Nurse Practitioner | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 103TH0004X Psychologist, Health | |
| 207K00000X Allergy & Immunology | |
| 207QA0505X Family Medicine, Adult Medicine | |
| 207QG0300X Family Medicine, Geriatric Medicine | |
| 251E00000X Home Health | |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2019-01-29 |
| Last Update Date | 2022-12-23 |