| NPI | 1962100685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMINIQUE S HARNAGE Owner 903-807-8281 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 363LX0106X Nurse Practitioner, Occupational Health |
| 363LA2200X Nurse Practitioner, Adult Health | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2023-02-21 |
| Last Update Date | 2023-04-27 |