| NPI | 1063260461 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT COOPER Owner 817-550-6230 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QM1300X Clinic/Center Multi-Specialty |
| Enumeration Date | 2024-05-09 |
| Last Update Date | 2024-08-02 |