| NPI | 1326435199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LACY DAWN BURKES Pediatric Nurse Practitioner 214-773-5669 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: TX 754047) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2015-04-20 |
| Last Update Date | 2023-01-26 |