| NPI | 1053584755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGARET C BASILIADIS Owner 817-605-1707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine Geriatric Medicine (Licence: TX K1776) |
| Enumeration Date | 2008-04-02 |
| Last Update Date | 2008-10-15 |