| NPI | 1104666551 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALTON DIVAKARAN CEO And President 972-900-1881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| 261QU0200X Clinic/Center, Urgent Care | |
| Enumeration Date | 2024-05-31 |
| Last Update Date | 2024-05-31 |