| NPI | 1174319024 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIO ANDINOVELEZ Chief Operating Officer 469-443-0742 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2025-04-17 |
| Last Update Date | 2025-04-17 |