| 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 |