| NPI | 1215212345 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON MEYER Authorized Official 817-263-9700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2011-10-20 |
| Last Update Date | 2022-02-25 |