| NPI | 1346071586 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA CHRISTINE RENFRO Cnp CFO/Cmo 817-897-5310 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology |
| 261QU0200X Clinic/Center, Urgent Care | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| Enumeration Date | 2024-08-09 |
| Last Update Date | 2025-06-25 |