| NPI | 1093140980 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINA ANN CHEN Provider 254-306-0347 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: TX M1579) |
| Enumeration Date | 2013-09-10 |
| Last Update Date | 2022-01-31 |