| NPI | 1184886640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLEN ROGERS Insurance Supervisor 817-315-2550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: TX G0037) |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2008-12-31 |