| NPI | 1023668100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL HEDTKE Sole Member 972-412-5299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 204R00000X Electrodiagnostic Medicine |
| Enumeration Date | 2019-09-19 |
| Last Update Date | 2021-05-05 |