| NPI | 1043576358 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY LEE LUGGER President 817-540-1755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: TX G2762) |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2012-05-10 |