| NPI | 1073748562 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDRIC CLARK PUCKETT Physician/Owner 972-875-6200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2009-05-27 |
| Last Update Date | 2024-06-13 |