| NPI | 1346517182 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN R WIECK Owner 940-322-9456 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: TX J0361) |
| Enumeration Date | 2011-11-22 |
| Last Update Date | 2012-10-09 |