| NPI | 1346468188 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEOPOLDO MARIO BASILICO President 972-267-6653 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TX K6534) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2011-11-02 |