| NPI | 1093251399 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OWEN OMORAGBON Owner 214-676-8716 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX AP127005) |
| Additional Taxonomies | 261Q00000X |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2017-01-10 |
| Last Update Date | 2018-01-09 |