| NPI | 1083154207 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY DOUGLAS MILLER Vice President 972-906-8103 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2017-03-07 |
| Last Update Date | 2022-02-28 |