| NPI | 1144608191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DURGA PRASAD MEKALA Director 817-987-1414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX P0385) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX N8039) |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2015-05-11 |