| NPI | 1124131040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANIS WILBERT Office Manager 214-369-8717 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX H0800) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 7536) |
| 207Q00000X Family Medicine (Licence: TX MD M0311) | |
| 207Q00000X Family Medicine (Licence: TX H7354) | |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2008-08-14 |