| NPI | 1346957677 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BIJU LUKOSE Manager 469-788-8588 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207RG0100X Internal Medicine, Gastroenterology | |
| 208600000X Surgery | |
| Enumeration Date | 2022-11-07 |
| Last Update Date | 2024-07-02 |