| NPI | 1144561762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HONG DAVIS Owner/Provider 972-867-5888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: TX K8107) |
| Enumeration Date | 2013-03-06 |
| Last Update Date | 2013-03-06 |