| NPI | 1346879848 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE VANZEE Credentialing Coordinator 469-401-8820 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207QA0505X Family Medicine, Adult Medicine | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LG0600X Nurse Practitioner, Gerontology | |
| 207QG0300X Family Medicine, Geriatric Medicine | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 363LA2100X Nurse Practitioner, Acute Care | |
| Enumeration Date | 2020-04-06 |
| Last Update Date | 2023-09-07 |