| NPI | 1972680130 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA M. JETTER President 903-526-7055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX E6235) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2022-08-16 |