| NPI | 1215240874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS GUS YIANTSOU President 817-283-5353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: TX E4781) |
| Enumeration Date | 2010-07-23 |
| Last Update Date | 2012-08-01 |