| NPI | 1255666251 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLON D PADILLA Board Member 214-956-6995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: TX K2254) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TX 558614) |
| Enumeration Date | 2009-10-08 |
| Last Update Date | 2009-10-08 |