| NPI | 1104218619 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANKIT PATEL Manager 469-348-8521 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: TX M8909) |
| Enumeration Date | 2015-02-21 |
| Last Update Date | 2015-02-21 |