| NPI | 1144792615 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY MCAULIFF Director 469-931-0684 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy |
| 208D00000X General Practice | |
| Enumeration Date | 2018-12-21 |
| Last Update Date | 2019-03-18 |