| NPI | 1043082464 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE KANN Vice President And Secretary 972-216-2299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2023-10-30 |
| Last Update Date | 2023-10-30 |