| NPI | 1326432246 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAN FREDERICK Owner 214-842-6460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2015-03-28 |
| Last Update Date | 2015-03-28 |