| NPI | 1114919172 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLEN ELIZABETH FOURTON Director 972-860-8649 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX 00997Y) |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2008-02-19 |