| NPI | 1265989081 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | JENNIFER LYNN ODEN Office Manager 972-581-9800 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine | 
| Additional Taxonomies | 207R00000X Internal Medicine | 
| Enumeration Date | 2016-09-09 | 
| Last Update Date | 2016-09-09 |