| NPI | 1265613319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOAN ELIZABETH WILSON Office Manager 817-685-6191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX J3990) |
| Enumeration Date | 2007-11-16 |
| Last Update Date | 2007-11-16 |