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 |