| NPI | 1003238056 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY MATHEW BURTON Owner 940-600-4861 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: TX N7403) |
| Enumeration Date | 2014-01-10 |
| Last Update Date | 2015-12-26 |