NPI | 1992708291 |
---|---|
Entity Type | Organization |
Authorized Contact | WAYNE HUDSON Administrator 903-592-6355 |
Organization Subpart ? | No |
Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease |
Additional Taxonomies | 363A00000X Physician Assistant |
2081P2900X Physical Medicine & Rehabilitation, Pain Medicine | |
Enumeration Date | 2005-05-31 |
Last Update Date | 2015-08-24 |