| NPI | 1265813372 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH KAYE HOLDEN Practice Manager 469-345-6464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2015-06-15 |