| NPI | 1235571340 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHONDA R GUITREAU Agent 214-382-1909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: TX K0566) |
| Enumeration Date | 2013-07-18 |
| Last Update Date | 2013-07-18 |