| NPI | 1003212440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANETTE ICHO President 214-491-4900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QA0000X Family Medicine Adolescent Medicine |
| 207QA0505X Family Medicine Adult Medicine | |
| Enumeration Date | 2014-11-12 |
| Last Update Date | 2014-11-12 |