| NPI | 1083039226 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRANCE PERKINS Director 214-928-9292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: TX 1079686-6591) |
| Enumeration Date | 2014-02-25 |
| Last Update Date | 2014-02-25 |