| NPI | 1053027680 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FOWAD CHOUDHRY Managing Employee 817-721-3145 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2023-01-26 |
| Last Update Date | 2024-05-24 |