NPI | 1033972716 |
---|---|
Entity Type | Organization |
Authorized Contact | BRIAN WHITE CEO 817-244-0101 |
Organization Subpart ? | No |
Primary Taxonomy | 208000000X Pediatrics |
Additional Taxonomies | 207R00000X Internal Medicine |
261Q00000X Clinic/Center | |
261QM1300X Clinic/Center Multi-Specialty | |
363A00000X Physician Assistant | |
363L00000X Nurse Practitioner | |
Enumeration Date | 2024-02-05 |
Last Update Date | 2024-06-13 |