| NPI | 1013022136 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY WAYNE HANSON Owner/Physician 817-504-5699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX M3571) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2020-08-22 |