| NPI | 1356973077 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE L WILIAMS CFO 214-763-1184 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2020-02-11 |
| Last Update Date | 2020-07-23 |