NPI | 1194153742 |
---|---|
Entity Type | Organization |
Authorized Contact | VICTORIA LYNN TYRA Nurse Practitioner/Owner 972-542-5811 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 584873) |
Enumeration Date | 2013-10-17 |
Last Update Date | 2014-06-30 |