| NPI | 1275875874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY ANN ROBINSON Admininstrator 214-520-1006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: TX P105) |
| Enumeration Date | 2013-03-21 |
| Last Update Date | 2013-03-21 |