NPI | 1164041521 |
---|---|
Doing Business As | PRENTISS FAMILY MEDICINE |
Entity Type | Organization |
Authorized Contact | ADRIENNE L PRENTISS Owner/Physician 817-251-1225 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Enumeration Date | 2020-04-15 |
Last Update Date | 2020-04-15 |