| NPI | 1073211959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHUNKEETHA LATRICE TOTSCH Family Nurse Practitioner 469-384-7781 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2023-02-20 |
| Last Update Date | 2024-04-06 |