| NPI | 1306143920 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATALIE J ENGELBART Owner 972-816-1410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: CO 5409) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: TX 7839) |
| Enumeration Date | 2011-02-16 |
| Last Update Date | 2013-05-22 |