| 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 |