| NPI | 1316136062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA DIONE MOORE Owner 972-867-1803 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TX K4963) |
| Enumeration Date | 2007-10-18 |
| Last Update Date | 2007-10-18 |