| NPI | 1164811964 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESA G ANSELL Owner 972-291-1992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: TX 08020) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2015-01-16 |
| Last Update Date | 2015-01-16 |