NPI | 1174553416 |
---|---|
Entity Type | Organization |
Authorized Contact | GONZALO VENEGAS Owner 214-942-3100 |
Organization Subpart ? | No |
Primary Taxonomy | 174400000X Specialist (Licence: TX H6974) |
Additional Taxonomies | 207Q00000X Family Medicine |
Enumeration Date | 2006-07-03 |
Last Update Date | 2023-03-31 |