| NPI | 1245571835 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLAUDIA CASTANO Manager 972-720-9943 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: TX K4647) |
| Enumeration Date | 2013-03-07 |
| Last Update Date | 2013-03-07 |