| NPI | 1164685244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA ANN LEDEZMA Medical Biller 817-626-9744 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TX E2171) |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2008-07-08 |