| NPI | 1114481561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GODLING OBI ONYEGBUNWA Administrator 972-704-5550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care |
| 363LF0000X Nurse Practitioner Family | |
| Enumeration Date | 2019-01-29 |
| Last Update Date | 2022-04-11 |