| NPI | 1366144123 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | APRIL POWELL Authorized Official/ Owner 972-938-3060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service |
| Enumeration Date | 2023-03-17 |
| Last Update Date | 2023-03-20 |