| NPI | 1295886455 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETTY TATE PETTIGREW Administrator 972-385-1333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: TX 008177) |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2020-08-22 |