| NPI | 1972391886 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAQUARRA LASTAYSHA MITCHELL Chief Executive Officer 903-787-2219 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2025-04-29 |
| Last Update Date | 2025-04-29 |