| NPI | 1063991404 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA BLAKELY Practice Administrator 214-445-6959 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WM0705X Registered Nurse, Medical-Surgical |
| Enumeration Date | 2018-08-07 |
| Last Update Date | 2018-08-07 |