| NPI | 1003019555 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PERRYK KENT BECKSTROM Sole Proprietor 214-381-7194 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX L9622) |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2008-09-17 |