Graduated: 2024
NPI: 1417544347
Practice Locations (2)
IMPACT PHYSICIAN GROUP, TEXAS, LLC
302 GOBBLERS KNOB RD
LUFKIN, TX 759045419
4692009159
SUPPORTIVE CARE OF TEXAS PC
825 W KEARNEY ST
MESQUITE, TX 751493206
8667081240
Source: CMS National Downloadable File, September 2026.