| NPI | 1144609215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNIELLE GREEN Owner / President 972-616-4932 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC 894) |
| Enumeration Date | 2015-05-22 |
| Last Update Date | 2015-05-22 |