| NPI | 1063601466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI BILLMAN Claims Manager 817-470-6676 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: TX H9968) |
| Enumeration Date | 2007-10-22 |
| Last Update Date | 2024-06-24 |