| NPI | 1346646528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE K TIMMONS Operations Manager 817-310-6050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: TX H6268) |
| Enumeration Date | 2014-11-14 |
| Last Update Date | 2014-11-14 |