NPI | 1144625674 |
---|---|
Entity Type | Organization |
Authorized Contact | MARY NICHOLAS MCNEILL Owner 214-701-9590 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: TX DT06756) |
Enumeration Date | 2014-10-27 |
Last Update Date | 2020-01-03 |