| NPI | 1144798083 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD CHARLES LE CARA Clinician 972-803-4432 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2018-11-08 |
| Last Update Date | 2021-09-23 |