| NPI | 1124032412 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETTY BRUMLEY Practice Administrator 214-509-9530 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TX H0458) |
| Enumeration Date | 2006-07-29 |
| Last Update Date | 2020-08-22 |