| NPI | 1073781050 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM J. VAN WYK President 817-877-3113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: TX D9696) |
| Enumeration Date | 2008-02-13 |
| Last Update Date | 2011-02-16 |