| NPI | 1073848925 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA HART Administrotor 972-869-1185 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: TX 801173670) |
| Enumeration Date | 2009-10-09 |
| Last Update Date | 2009-10-09 |