| NPI | 1346600210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY MOODY Owner/Provider 214-908-9463 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP126911) |
| Enumeration Date | 2016-03-04 |
| Last Update Date | 2016-03-23 |