| NPI | 1013937598 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA W GENECOV Owner 972-566-8466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2020-08-22 |