NPI | 1366113177 |
---|---|
Doing Business As | VARSITY HEALTH MAJ002 |
Entity Type | Organization |
Authorized Contact | MOUZON BASS Administrator/Agent 972-367-4845 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Enumeration Date | 2021-09-22 |
Last Update Date | 2021-09-22 |