| NPI | 1073799607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLI WHITE Doctor 972-540-0567 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: TX 9933) |
| Enumeration Date | 2008-01-14 |
| Last Update Date | 2020-09-16 |