| NPI | 1235135906 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLEN ELIZABETH FOURTON Director 972-860-8649 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX 00T04Z) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX 00T04Z) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: TX 00T04Z) | |
| 207RI0008X Internal Medicine, Hepatology (Licence: TX 00T04Z) | |
| 207RR0500X Internal Medicine, Rheumatology (Licence: TX 00T04Z) | |
| 208600000X Surgery (Licence: TX 00T04Z) | |
| 208800000X Urology (Licence: TX 00T04Z) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX 00T04Z) | |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2012-09-04 |