| NPI | 1215166954 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NEVA M JACKSON Offfice Manager 817-481-5863 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX M6301) |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2009-07-02 |