| NPI | 1295130300 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT RADER Owner / President 972-616-4932 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2014-10-31 |
| Last Update Date | 2016-04-19 |