| NPI | 1033563127 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAELYNN GOODMAN Billing 469-531-2000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TX pa03903) |
| Enumeration Date | 2016-04-15 |
| Last Update Date | 2016-04-15 |