| NPI | 1235890195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY FRANCES ELLIS Nurse Practitioner 817-908-5519 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2022-01-04 |
| Last Update Date | 2022-02-21 |