| NPI | 1174024731 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRAVICIA LACOLE GARRETT Owner/ Nurse Practitioner 214-966-3070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2018-02-27 |
| Last Update Date | 2018-06-16 |