| NPI | 1366620460 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAN R STOCKARD Owner 940-626-4040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: TX E6970) |
| Enumeration Date | 2008-01-31 |
| Last Update Date | 2009-01-07 |