| NPI | 1205948486 |
|---|---|
| Doing Business As | PROVIDENT FAMILY HEALTHCARE |
| Entity Type | Organization |
| Authorized Contact | REBECCA HURLEY Senior Vice President 214-473-3993 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-08-22 |