| NPI | 1255337275 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLEN ELIZABETH FOURTON Director 972-860-8649 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TX 00R87R) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX 00R87R) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: TX 00R87R) | |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: TX 00R87R) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX 00R87R) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: TX 00R87R) | |
| 207RR0500X Internal Medicine, Rheumatology (Licence: TX 00R87R) | |
| Enumeration Date | 2005-06-23 |
| Last Update Date | 2010-04-22 |