| NPI | 1184304743 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL MARCIANO President 817-915-3557 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| 2083S0010X Preventive Medicine, Sports Medicine | |
| Enumeration Date | 2023-07-19 |
| Last Update Date | 2023-07-19 |