| NPI | 1285165332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KOLAWOLE ODUMUSI Owner 432-695-6300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX Q5518) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX P4362) |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2022-10-16 |