| NPI | 1093298036 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANNA L GOMEZ Administration 972-222-8001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2018-09-14 |
| Last Update Date | 2018-09-14 |