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 |